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Blog

Why Doesn't Insurance Cover Personal Training?

7/22/2020

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It is true that there are many ailments and diseases out there that cannot be helped because of genetic or environmental reasons.

However, the United States Center of Disease Control (CDC) states that up to 80% of chronic diseases can be eliminated with three simple lifestyle changes:
      1) improved diet
      2) increase in activity
      3) quitting smoking
Chronic diseases, according to the CDC, are those that are ongoing and generally incurable, but are often preventable illnesses or conditions. Think heart disease, asthma, and diabetes.

Chronic diseases are the leading cause of death and disability in America afflicting 133 million Americans (45% of the population) and are responsible for seven out of every ten deaths in the US.

With this in mind, it should be no surprise that people with chronic illnesses are the most frequent users of health care in America. Chronically ill patients account for 81% of hospital admissions, 91% of prescriptions filled, and 76% of physician visits.

Out of the approximately $2 trillion spent on public and private health care in 2005, 75% went toward treatment of chronic conditions. So, if prevention is often the best treatment plan for these illnesses, why aren’t insurance companies investing in prevention plans?

Well, turns out they do. But only if you are medically referred by a doctor. Conditions that require treatment that insurance will cover personal training costs for include:
  • back pain
  • sports injuries
  • diabetes
  • arthritis
  • joint replacements
  • hypertension
  • cardiac rehab
  • morbid obesity
 
If you didn’t notice, half of those are chronic conditions and all of them are conditions that one already has to be afflicted with prior to insurance paying for personal training services. According to exercise.com, “[f]or a client’s health insurance company to pay for training sessions, the fitness plan must be medically necessary for their condition”.

​Interesting… it seems to me that there needs to be more emphasis on what we can do to prevent these things instead of reactively treating them once a person finds themselves in pain.
 
Just some food for thought.
"A reminder is only a reminder if it's given before it's needed."
​                                                                                          - Anonymous

Works Cited
  1. https://www.fightchronicdisease.org/sites/default/files/docs/GrowingCrisisofChronicDiseaseintheUSfactsheet_81009.pdf
  2. https://www.exercise.com/learn/can-personal-trainers-bill-insurance-companies/
  3. https://www.exercise.com/learn/does-health-insurance-pay-for-personal-trainers/
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