Personal Trainer: Tax Deduction, Insurance Coverage, and The Letter of Medical Necessity

Getting a Tax Deduction and Health Insurance Coverage for your Personal Training

Wondering if you can deduct personal training sessions a taxable deduction?  What if you could actually have your insurance cover it?  Step one is to use our Online Letter of Medical Necessity Generator.  You’ll also find a sample PDF of Letter Medical Necessity to hand to your doctor.

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The real key to qualifying for insurance and/or getting a taxable deduction is getting a LETTER OF MEDICAL NECESSITY.  Health Insurance Companies like Carefirst, Aetna, and Blue Cross have policies in place to help you.

Medical Necessity Defined: A service may be considered medically necessary if the service or benefit will, or is reasonably expected to:

  • Prevent the onset of an illness condition, or disability
  • Reduce or ameliorate the physical, mental, or developmental effects of an illness, condition or disability.
  • Assist the individual to achieve or maintain maximum functional capacity in performing daily activities taking into account both the functional capacity of the individual and those functional capacities that are appropriate for individuals of the same age.

How to Obtain a Letter of Medical Necessity for a Personal Trainer?

Talking to your doctor is the first step. A physician may write you a letter of medical necessity for the services of a personal trainer if he/she believes that it could have a positive benefit for the treatment of a medical condition.

This letter should outline how your medical condition necessitates a personal trainer, and how the treatment will be used to alleviate the issue and how long the treatment will last. If the treatment plan exceeds the current plan year, another Letter of Medical Necessity will have to be provided to the benefits administrator to cover the duration of the treatment. (FSA Store)

Looking for more Personal Trainer Resources?  Check out all of the articles and resources we have for the career personal trainer.

Qualifying ExpensesNon Qualifying Expenses

Weight-Loss Program

You can include in medical expenses amounts you pay to lose weight if it is a treatment for a specific disease diagnosed by a physician (such as obesity, hypertension, or heart disease).” 1

Personal Trainers

Costs for a personal trainer used merely to improve general health and well-being are ineligible. The service is only covered when recommended by a healthcare professional to treat a medical condition. A physician’s prescription is required.

Health Club Dues

You can’t include in medical expenses health club dues or amounts paid to improve one’s general health or to relieve physical or mental discomfort not related to a particular medical condition. You can’t include in medical expenses the cost of membership in any club organized for business, pleasure, recreation, or other social purpose.” 2

Athletic Apparel and Supplements

In general gym and fitness apparel as well as common bodybuilding supplements are not tax deductible.

Health Conditions That May Be Covered by Insurance

Treatment for these Health Conditions May be Tax Deductible

Asthma and Sleep Apnea
Fatal breathing conditions such as asthma and sleep apnea are often caused or exacerbated by being overweight.
Cancer
Obesity is thought to be a risk factor for certain cancers, such as uterine, ovarian, cervical, breast, colorectal and prostate cancer. In fact, the World Health Organization estimates that nearly 30 percent of global cancer cases can be attributed in part to excess weight gain and inactivity. (www.mediweightloss.com)
Depression
Regular exercise probably helps ease depression in a number of ways, which may include: Releasing feel-good brain chemicals that may ease depression(neurotransmitters, endorphins and endocannabinoids) Reducing immune system chemicals that can worsen depression.
Fatty Liver Disease
Although there is no specific treatment for fatty liver disease, patients are generally advised to lose weight, eat a healthy diet, increase physical activity, and avoid drinking alcohol. If you have fatty liver disease, lowering your body weight to a healthy range may improve liver tests and reverse the disease to some extent.
Fibromyalgia
Strength training exercises increase your muscle strength and can make daily activities, such as climbing stairs and carrying laundry, easier.  Stronger muscles use less effort to do work than weaker muscles.  Some think that by using less effort, your muscles do not get as fatigued. For many years, when Fibromyalgia was thought to be a disorder of the muscles, people believed that you might damage muscle if you exercised it too hard. Therefore, people with Fibromyalgia were discouraged from doing strength training type exercise. Today, research demonstrates the safety and benefit of this important type of exercise for the person with Fibromyalgia.” (http://www.fmcpaware.org/)
GallBladder Disease
Increased cholesterol and body fat are key components in the development of gallbladder disease. About 25 percent of obese people develop gallbladder stones and require surgery as a result.
Gallstones
There are a number of potential pathways that may explain the beneficial effects of exercise besides weight control. Physical activity has been shown to make the gut move more rapidly, which may prevent gallstones from forming. In addition, it may reduce levels of fatty substances called triglycerides, which play a role in the development of gallstone.
High Blood Pressure
Having a large body size may increase blood pressure because your heart needs to pump harder to supply blood to all your cells. Excess fat may also damage your kidneys, which help regulate blood pressure. Weight loss that will get you close to the normal BMI range may greatly lower high blood pressure.
High Cholesterol
Cholesterol is found in lipids in the bloodstream. Although it may be inherited, it’s often caused by poor diet and lack of exercise.  In some cases, it can be reversed by switching to a diet low in saturated fat and increasing exercise.
Kidney Disease
If you are in the early stages of chronic kidney disease, losing weight may slow the disease and keep your kidneys healthier longer.
Gout
Exercise can absolutely help you keep your gout in check and promote faster healing. The right exercises can reduce pain and increase your energy as well as keep you in shape by maintaining a healthy body weight and building healthy bones, joints, and muscles.
Liposuction
Removing fat from your abdominal area may cause you to gain dangerous visceral or belly fat. This type of fat is stored around the organs deep within your abdomen, and it increases your risk for heart disease and diabetes.” (http://www.webmd.com/) If someone chooses to undergo liposuction, it is very important, if not essential, that this person exercises after the surgery,” researcher Fabiana Braga Benatti, PhD, of the University of Sao Paulo in Brazil, says in a news release.
Restless Leg Syndrome
“A review published in the journal Neuropsychiatric Disease and Treatment analyzed studies done on the effect of exercise on RLS. The analysis concluded that exercising three days a week, with a combination of lower-body resistance training work and aerobic exercises, helps manage the severity of restless legs syndrome symptoms. It also found that a lack of exercise is a major risk factor for the disease. http://www.everydayhealth.com/
Osteoarthritis
For those who are overweight or obese, losing weight may help reduce the risk of developing osteoarthritis. Weight loss of at least 5 percent of your body weight may decrease stress on your knees, hips, and lower back and lessen inflammation in your body. If you have osteoarthritis, losing weight may help improve your symptoms. Research also shows that exercise is one of the best treatments for osteoarthritis. Exercise can improve mood, decrease pain, and increase flexibility.​
Osteoporosis
Resistance training helps with osteoporosis because it strengthens muscle and builds bone. Studies have shown that resistance exercise increases bone density and reduces the risk of fractures.
Type 2 Diabetes
Type 2 diabetes affects the way your body metabolizes sugar by either resisting or not producing enough insulin. Healthy diet, exercise and weight loss can help treat or prevent type 2 diabetes.

Tax Deductions for Personal Training?

Yes, you can deduct the costs for Personal Training in certain instances.  Generally, if you qualify for a Letter of Medical Necessity, your costs for obtaining Personal Training will be tax deductible.

Eligible Healthcare Expense Substantiation

All claims will require some form of substantiation, regardless of the items’ eligibility. Acceptable documentation to support your claim could include: receipts, invoices, itemized billing statements from the service provider. They should include: date of service, name of the provider, description of the services provided/goods purchased, and the cost of services. Ineligible documentation generally includes: bank statements, illegible documents, and any documentation that does not clearly indicate all of the above information.  For more information: please visit: www.irs.gov

Summary of Tax Deductions for Personal Training

Flexible Spending Account (FSA)Limited Care FSADependent Care FSAHealth Savings Account (HSA)Health Reimbursement Account (HRA)
Eligible with LMN

X

X

X

Not Eligible

X

X

Example Letter of Medical Necessity

Helpful Tips For Letters of Medical Necessity:

  • Cite past successes with the treatment.
  • Cite recent medical articles.
  • Include letters from consultants including physical or occupational therapists
  • Review previous and failed treatments.
  • Address the HMO’s suggested treatments.
  • Be specific about psychological factors that are relevant to your chosen treatment.
  • Provide information you have which a distant administrator may not know.
  • Cite conversations with family members or other treating physicians.

Example Letter of Medical Necessity:

Date
Medical Director
Health Plan
Address
Fax:

Regarding: Patient Name; Date of Birth; Insurance ID number

Greetings:

I am writing to request [insert service or equipment request] for my patient [name of patient] who has the following diagnoses relevant to this request: [list diagnoses].  This request is medically necessary for the following reasons: [choose one or more of the reasons]

It will, or is reasonably expected to, prevent the onset of an illness, condition, or disability. [Please provide details]

It will, or is reasonably expected to, reduce or ameliorate the physical, mental, or developmental effects of an illness, injury, or disability. [Please provide details]

It will assist the individual to achieve or maintain maximum functional capacity in performing daily activities, taking into account both the functional capacity of the individual and those functional capacities that are appropriate for individuals of the same age. [Please provide details.]

Please let me know if you require additional information from my records.

Yours truly,

[name and signature]

Health Insurance Companies & Resources

CareFirst:

https://provider.carefirst.com/carefirst-resources/provider/pdf/pre-service-review-request-for-authorization-form-cut9045.pdf

Anthem Blue Cross Blue Shield:

https://www.anthem.com/wps/portal/ahpprovider?content_path=shared/va/f3/s6/t0/pw_m008961.htm&state=va&label=BlueCare%20Disclaimer

Aetna: “Medical necessity is more than being ordered by a doctor. “Medically necessary” means your doctor ordered a product or service for an important medical reason. It might be to help prevent a disease or condition. Or to check if you have one. Or it might be to treat an injury or illness. The product or service:

  • Must meet a normal standard for doctors •Must be the right type in the right amount for the right length of time and for the right body part •Must be known to help the particular symptom •Cannot be for the member’s or the doctor’s convenience •Cannot cost more than another service or product that is just as effective.

http://www.aetna.com/individuals-families-health-insurance/document-library/documents/HMO/01_28_325_1_VA_1_11.pdf

Innovation Health:

https://www.aetna.com/health-care-professionals/precertification/precertification-lists.html

Kaiser Permanente:

https://providers.kaiserpermanente.org/info_assets/cpp_mas/mas_provman_ch9_Oct2011.pdf

Optima Health

https://providers.optimahealth.com/medical/Pages/PriorAuthorizationForms.aspx

Piedmont Community Healthcare: Medically Necessary services or Medical Necessity refers to those Covered Services that Piedmont determines are: (1) consistent with the diagnosis and treatment of the Insured’s condition; (2) are appropriate given the circumstances and the symptoms; (3) are provided to treat the condition, illness, disease or injury; (4) are in accordance with standards of good medical practice; (5) are not primarily for the convenience of the Insured or the Provider; and (6) with respect to Inpatient care, are provided to treat a condition requiring acute care as a bed patient. Piedmont will determine the Medical Necessity of a given service or procedure

https://www.pchp.net/index.php/…/1377-2016-ppo-ind-policy-book-final-2.html

Disclaimer: Please consult with your tax adviser to determine your eligibility. 
Nothing in this communication is intended to constitute legal or tax advice.
  1. IRS Publication 502, IRS.gov
  2. IRS Publication 502, IRS.gov

About Coach Paul

Paul Bio PictureView my Bio | Email me
BioMedical Engineering - Johns Hopkins University.
Juris Doctorate - Rutgers.
M|WOD, CrossFit Level II, 3DMAPS, FMSII, YBT, RKC, TRX, PN.

Paul has trained over 3000 clients and more than a 100 personal trainers over his 10 years as a mobility and strength coach.  He emphasizes safety and corrective exercises in all programming (strength, weight loss, conditioning, etc.)  His practice focuses on improving flawed movement patterns to prevent injury and improve skeletal-muscular function.  Paul employs a balanced approach in training utilizing his training Yoga, CrossFit, Powerlifting, and Movement Courses to systematically strengthen weakened muscles and mobilize joints and muscle tissue.  Move Better ... Train Better.