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  • Fitness Reimbursement Form

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Fitness Center Reimbursement for Network Health Medicare Advantage (PPO) Members Member name Member ID# Fitness Center/Provider Information Name of Center Street Address City State Zip Please attach.

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We'll reimburse you for fees you pay toward a fitness facility or other qualified membership, including virtual fitness subscriptions! Getting reimbursed is simple.

Get a reward for working out Eligible Tufts Health Together (MassHealth) members can receive a reimbursement of up to $30 once every calendar year for a gym membership or fitness-related activity.

How do I qualify for fitness reimbursement? You must be eligible for fitness reimbursement through your Harvard Pilgrim plan. Qualified fitness facility membership or fitness class subscription must be for at least four months in a calendar year.

There is a $300 maximum reimbursement per Harvard Pilgrim policy in a calendar year per family contract, and no more than two covered members may receive reimbursement. For individual contracts, the maximum reimbursement amount is $150.

Harvard's athletics facilities and resources are available to staff, faculty, students, alumni and eligible family members. Annual or semester memberships, expert personal training and fitness classes offer as many options as private gyms, at reasonable rates.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232