My Insurance Aviator Program – An Entry into the Reimbursement System
Reimbursement – the Holy Grail
Over the past 30 years professionals in the exercise field have been interested in receiving reimbursement dollars for specific types of fitness services. The only bona fide service that started receiving insurance money was cardiac rehab, which in the mid-1980s received reimbursement for up to 35 cardiac visits. This meant that patients who needed exercise could get phase 3 programs for up to 3.5 months post-surgery. No other types of clinical exercise – obesity, hypertension, diabetes management, etc. received reimbursement dollars.
The Reimbursement System over the past 25 years
Other types of “wellness” services such as massage therapy and nutrition advice also had a difficult time receiving third party payments. Even though these services are essential and could be argued to be “medically necessary” – they usually didn’t receive money, with the exception of a few creative therapists along with their physicians or health systems.
Silver Sneakers and the Entre into Health Insurance
In the early 1990s, the Silver Sneakers program, which provided free health club members to senior citizens through their Medicare programs, became a “thing” in the US. The program spread to over 10,000 clubs, and millions of eligible seniors could sign up. It became a great deal for Silver Sneakers, but some clubs argued that the program didn’t pay much to them – and when enough seniors DID sign up for programs, clubs actually lost money.
Covid Closures – Seeing a different future
As health clubs closed during Covid – they felt helpless to cater to their members, and even though data came out to prove that clubs were safe, and those who trained in fitness has much better covid outcomes, the issue became - “how can clubs become essential?” Part of this answer may come from using insurance benefits to pay for specific health club programs.
What about insurance can affect health clubs
Health insurance is a contract between a consumer and a company. Many companies have employer-based programs that include “perks” within such a contract. These may include types of health club programs. The issue then becomes that most consumers have no idea what types of components their health plans actually pay for. This is where the Health Aviator comes in. Essentially a type of consumer coaching program – the Aviator will assist the consumer with elements of their plan and guide them as to what types of programs and aspects of their plan that may be covered under their current policy.
Part of this navigation would include specific types of programs in health clubs that may be covered under their overall health plan, their Health Savings Account, or HSA plan, or employer-sponsored HRA insurance. These programs may include a specific number of personal training sessions – for something such as weight loss programs, nutrition guidance, or massage therapy for general pain management.
My Insurance Aviator program is actually a good deal for clubs – as the small charge for consumers costs nothing for the health club. Clubs may receive a referral fee from the Aviator program for each person who signs up or who may be entitled to a policy change that reflects the use of health club services.
What do clubs need to know?
Health clubs should be doing everything they can in order to attract new members, retain current members, and develop additional revenue streams. My Insurance Aviator may be a critical revenue stream in that it may allow a large percentage of current health club members to have programs paid for by insurance – thus saving them money and adding potential revenue streams to the club they otherwise may not have attained.
Health club members always have questions about insurance. According to Life Core Group – almost half of consumers don’t ask about plans because they are confused by the complexity. The Aviator program solves all of these problems and improves the odds of having insurance pay for what consumers WANT from their health plans – preventive and proactive programs that improve health and save money. The goal for the Aviator program is to be in every health club in the US within the next two years.
Who you gonna call?
Your best bet is to contact a Life Core Group representative for more information – the number is 602-235-2800 X-13
www.lifecoregroup.com/membership