Like individuals and families each fall the Y eagerly awaits open enrollment announcements from the major insurance carriers. Which plans are they keeping? Are there new plans with different qualification criteria? What are the reimbursement rates for the Y?

It’s been about 9 years since the government began the practice of hiring third party vendors to work with insurance carriers to offer free or reduced rate fitness memberships through insurance plans to Medicare eligible clients. It was an exciting time for Ys across the nation as we were coming out of the recession. Today the plans are an embedded part of the Medicare culture and somewhat problematic for local YMCAs. The free membership is a wonderful perk to our area residents but lesser known is that the reimbursement rate which the Y receives is significantly lower than our normal membership rate and it is only received if the insured person is actively using the Y. This results in more members but less income for the Y and its operations. Each vendor seeks a contract with the Y but not all offers are the same. Some offer extremely low reimbursement rates which would cause harm to the Y. All have stipulations to the amenities and classes we must offer and these come at an additional cost. The carriers also make changes to their plans annually. The Y often receives the blame for these changes and the impact they make on local residents while the truth is we are powerless in these transactions.

The silver lining for both area residents and the Y is that some plans now make it possible for the Y to provide services in remote locations, closer to the homes of the insured. The Y has the training and certification systems in place to provide highly qualified instructors but we don’t have access to venues to host these classes in neighboring communities. I invite anyone with an interest in bringing specialized classes for the Medicare eligible population in your community to reach out to the Y. With your assistance there is a good opportunity to find a venue and the staff to better serve the communities in the Marshall area.