Experts say your health insurance should cover gym memberships to prevent cancer from coming back. Why don't they?

“From 2009 through 2024, a total of 889 patients underwent randomization to the exercise group (445 patients) or the health-education group (444 patients),” the study noted. “At a median follow-up of 7.9 years, disease-free survival was significantly longer in the exercise group than in the health-education group.”

Gym memberships remain hard to get for cancer patients

Even as the data show exercise is a proven cancer reducer, patients — especially those with limited budgets — struggle to access the programs physicians recommend. Inefficient health insurance is the main barrier. Typical plans do not cover the fitness regimens needed to help push cancer into remission.

“This issue is personal,” Jennifer Grehan, a U.S.-based Pilates instructor and founder of The Core Collab, where she has coached post-cancer patients, told Moneywise. “My best friend was diagnosed with cancer in her 40s. She trained on the Pilates reformer all through her treatment.”

Grehan’s friend didn’t beat cancer, but she lived about ten years past her prognosis.

“They were good years,” Grehan noted. “I watched what supervised strength work gave her: the energy to get through treatment days and the strength to keep living her life.”

A basic gym membership is unlikely to solve the cancer-exercise conundrum, though.

“Someone in or after treatment can’t be put on a fixed program,” Grehan said. “Cancer-related fatigue changes week to week, sometimes hour to hour.”

That can mean peripheral neuropathy alters how a patient’s feet feel the floor. After breast surgery, a shoulder may go halfway up. Lymphedema risk changes how that arm can be loaded.

“My job is to read all of that every session and adjust,” Grehan noted. “A gym card can’t do that if insurers cover the building instead of the coaching; they’ll pay for the part that doesn’t work.”

Health insurers are being ‘penny-wise and pound foolish’

If exercise were a prescription drug, experts say health insurers would already be paying for it. Given the evidence, why aren’t insurers treating supervised exercise as medically necessary?

“Exercise is such a powerful tool for improving health and reducing the risk of illness and disease,” Fitz Koehler, fitness expert, cancer survivor, and author of Your Healthy Cancer Comeback, told Moneywise. “It’s penny-wise and pound-foolish for health insurance companies not to invest in programs that help patients stay active and strong. Classes, trainers, memberships, and support programs can all be incredibly beneficial, particularly for people navigating cancer treatment and recovery.”

There is also a strong financial case for coverage.

“Spending $1,000 or less per year on a gym membership or fitness program seems like a smart investment when you consider the potential costs of medical procedures, medications, hospital stays, and long-term care,” Koehler said.

Keeping cancer patients active and strong throughout treatment can help improve quality of life and physical functioning, potentially reducing the need for extra medical care.

“From my own history, investing in exercise is far more sensible than waiting until patients experience complications that require expensive interventions,” Koehler said. “If customers invest proactively in their health, insurers should be encouraging that behavior. It’s a win-win.”

Insurers say they’ll cover fitness programs

Insurance companies say they’re open to covering cancer patients’ fitness programs, but the burden of proof is on them.

“Supervised programs may be considered by insurers if the programs can reduce the cost of care and improve the health of beneficiaries,” Nathan Weller, an insurance advisor at Insurpedia, told Moneywise. “Insurers evaluate fitness on a case-by-case basis. Depending on the policy, as well as other factors such as the provider and the reason the fitness program was prescribed, fitness programs may be covered.”

Defining quality fitness care for cancer patients is at the core of what insurers approve or deny.