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Fitness Reimbursement Form For Anthem members in New 2026

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The Fitness Reimbursement Form is designed for Anthem members in New Hampshire to request reimbursement for fitness expenses. Members must complete all unshaded areas, attach original receipts, and obtain signatures from both the member and a fitness center employee. The form must be submitted to Anthem's Claims Department, and processing may take 6-8 weeks. Reimbursements will be denied if eligibility requirements are not met or if the form is incomplete.

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Click ‘Get Form’ to open the Fitness Reimbursement Form in the editor.
Begin by filling in your personal information in the 'Member Information' section. Include your last name, first name, member identification number, date of birth, group name, and sex.
Next, complete the 'Subscriber Information' section with the subscriber's details including their last name, first name, address, city, state, ZIP code, and phone number. If this is a new address, check the appropriate box.
In the 'Workout Period' section, indicate the dates of your fitness activities and enter the amount you paid for membership.
Ensure that both you and a fitness center employee sign at the bottom of the form to authorize release of information necessary for processing.
Finally, attach original receipts to the back of this form and send it to Anthem’s Claims Department as instructed.

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2020	4.2 Satisfied (32 Votes)
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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What is the Anthem Member Appreciation Program?

Through our Healthy Rewards Program, Medicaid members covered by Anthem Blue Cross and Blue Shield HP (Anthem) can earn $10 to $50 for getting certain health services. At the same time, you increase your practices quality scores by providing members with the vaccinations, screening visits, and medications they need.

How to get reimbursed by insurance for gym membership?

Yes - depending on your plan, you can legitimately get insurance to pay for your gym membership. The physician prescription is generally a key requirement to getting this accepted, but there are some plans that include a provision for gym memberships regardless of scripts though.

Does Anthem reimburse gym memberships?

Gym Reimbursement You can get money back when you meet the minimum number of gym visits. Qualifying fitness centers are in the U.S. and offer regular programs like cardio, flexibility, and weight-training. Log in to discover the detail about gym reimbursement.

How to get a reimbursement from Anthem?

How Does Anthem Claims Processing Work? After your visit, your doctor sends a bill to Anthem for the care you received during your visit. Or you can submit a claim for the services you received. A claims processor will check the claim for completeness, accuracy, and whether the service is covered by your plan.

How to get your gym membership reimbursed?

For a gym membership to even be considered for reimbursement under a Health Care FSA, you must have: Approved Letter of Medical Necessity (PDF) on file for a medical condition that requires exercise at a gym. Individual gym membership contract on file (multi-person contracts will not be considered)

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What fitness expenses qualify for reimbursement?

Eligible Expenses Your employer determines which expenses are eligible for reimbursement under the Fitness Reimbursement Program. Typical eligible expenses include: Gym, fitness center/studio, health club, swim tennis club memberships and fees. Fitness and nutrition counseling.

Will health insurance pay for a gym membership?

Most commercial health insurance plans offer fitness incentive programs, and those perks sometimes include free gym membership. If your plan wont fully reimburse your membership, you may still be able to get a low-cost or discounted gym membership or other fitness benefits.