How to Fill Out and Submit Your MassHealth Gym Reimbursement Form

To claim your MassHealth gym reimbursement, download the fitness reimbursement form from your specific managed care plan, attach dated proof of payment, and mail or upload it before the plan’s deadline. The form is not a single statewide document. WellSense, Mass General Brigham ACO, Tufts Health Together, and Fallon Health each publish their own version, with annual caps running from $30 to $250 per family.¹ Check the front of your member ID card for your plan name before you start.

Find the Right Form for Your Plan

Using the wrong plan’s form will get your request rejected. Each carrier publishes its own:

WellSense: The “Get Fit! Reimbursement Form” is available on the WellSense website or by calling member services. Reimbursement is up to $200 per family for fitness club memberships, plus a separate $100 per family for Weight Watchers.²
Mass General Brigham ACO: The Fitness Benefit Coverage Request Form is on the Mass General Brigham Health Plan resources site, or you can complete it directly in the member portal at Member.MassGeneralBrighamHealthPlan.org. The benefit pays $50 per person, up to $250 per family (member plus up to five family members).³
Tufts Health Together: The EXTRAS Fitness Reimbursement Form is on the Tufts Health Plan website, or call 888-257-1985 for a mailed copy. Reimbursement is up to $30 per member, once every 12 months.⁴
Fallon Health: Log into the MyFallon portal or call MassHealth customer service at 1-800-341-4848. The amount depends on your specific plan design.⁵

If your plan is not on this list, call the member services number on the back of your card and ask whether a fitness benefit is included.

Confirm You Meet the Eligibility Rules

Filing a form you are not yet eligible to submit is one of the most common reasons for denial. Every plan that offers this benefit requires a minimum period of active enrollment first.

WellSense and Mass General Brigham both require at least three months of active membership in the same calendar year as the fitness expense.²³ Tufts Health Together also requires three months of gym membership or completion of an eligible activity, plus approval from your primary care provider before you start.⁴

Your health plan enrollment and your gym membership must overlap. Paying for a gym in January and then enrolling in MassHealth in April does not count. If you switched plans mid-year, file with the plan that covered you during the months you paid, and only if you met that plan’s minimum enrollment period. WellSense’s form, for example, requires you to have been a WellSense member at the time of purchase and for at least three months, and does not credit time with another carrier.²

Members under 18 need parental permission under Tufts Health Together rules, and the same general principle applies at other plans.⁴ If you are not sure whether your activity qualifies (dance classes, sports leagues, virtual subscriptions, and weight-management programs are treated differently by each plan), call your plan’s member services line before you pay. A quick phone call avoids a denial later.

Fill Out the Form

Every version of the form asks for the same core information:

Your full name
Your member ID number (on the front of your health plan ID card)
The name and address of the fitness facility
The dates of your membership period
The total amount you paid

Some forms add extra fields. The Mass General Brigham form uses checkboxes to indicate whether the reimbursement is for yourself, family members, or both, since the $250 family cap can cover up to five additional people.³ If you are claiming for multiple family members, list each one with their individual member ID.

Double-check the dates. Membership dates that fall outside your plan enrollment window will trigger a denial even if everything else is in order.

Attach Proof of Payment

The form by itself is not enough. You need documentation showing that you actually paid. Plans generally accept:

Dated receipts from the fitness facility
Facility statements listing your membership period and fees
Bank or credit card statements showing the charges
A copy of your fitness facility agreement or contract

WellSense specifically asks for copies of receipts, facility statements, or bank statements for all payments made during the year, plus a copy of the gym contract.² Fallon requires documentation from the club showing contract dates and enrolled members, together with dated receipts or bank statements that show the member’s name, the activity, and the fees paid.⁵

Keep copies of everything you send. If mail goes missing, you will need to reconstruct the packet from your own files.

Submit the Packet

Submission methods vary. Some plans give you an online portal with instant confirmation; others accept mail only.

WellSense: Mail to WellSense Health Plan, Attn: Fitness Reimbursement, 100 City Square, Suite 200, Charlestown, MA 02129. Fax to 617-897-0884 or email to IncomingMarketingMail@wellsense.org.²
Mass General Brigham ACO: The fastest option is the member portal at Member.MassGeneralBrighamHealthPlan.org, which gives an immediate confirmation receipt. You can also mail to Mass General Brigham Health Plan, Attention: Claims/Fitness, 399 Revolution Drive, Suite 810, Somerville, MA 02145, or fax to 617-526-1902. Mailed and faxed submissions do not receive a confirmation.³
Tufts Health Together: Mail the completed form and original receipts to Tufts Health Plan, Attn: Claims Department, P.O. Box 524, Canton, MA 02021-1166.⁴
Fallon Health: Send to the address printed on your specific reimbursement form. Call 1-800-341-4848 if you are unsure which form or address to use.⁵

Mass General Brigham ACO limits you to one request per calendar year, so bundle all your receipts into a single submission rather than filing month by month.³

Deadlines

Most plans set the deadline at March 31 of the year after the membership period. WellSense and Mass General Brigham both use this date.²³ Fallon uses a different window: requests must be submitted within three months of the end of your benefit year or your last day of coverage.⁵ None of the plans mention hardship waivers or extensions, so treat the cutoff as firm.

When to Expect Payment

Processing times depend on your plan and your submission method:

Mass General Brigham ACO: 15 to 30 days for online submissions; 30 to 45 days for mailed or faxed forms. If selected for audit, add another 14 days.³
WellSense: six to ten weeks from the date of submission.²
Fallon Health: four to six weeks from receipt.⁵

If approved, you receive a reimbursement check or direct payment for the amount verified by your receipts, up to your plan’s annual cap.

If Your Claim Is Denied

Denials usually come down to a few predictable issues: the facility does not meet your plan’s definition of a qualifying fitness center, the documentation is incomplete, or you had not been enrolled long enough. Compare the denial letter against your plan’s rules before you escalate. Sometimes the fix is simply resubmitting with a missing receipt or correcting the dates.

If you believe the denial is wrong, MassHealth members have the right to appeal decisions made by their health plan. Start by contacting your plan’s member services line, or go through MassHealth directly.⁶ Keep the original submission, the denial letter, and notes from any follow-up calls, so you can point to exactly what was sent and when.

1
Mass.gov. Full List of MassHealth ACOs and MCOs
2
WellSense Health Plan. Get Fit! Reimbursement Form
3
Mass General Brigham Health Plan. Mass General Brigham ACO Fitness Benefit Coverage Request Form
4
Tufts Health Plan. Fitness Reimbursements
5
Fallon Health. It Fits! Fitness Reimbursement
6
Mass.gov. How to Appeal a MassHealth Decision