Wellness Wallet Benefit

Use Your Wellness Wallet to Stay Fit and Well!

Your flexible Wellness Wallet benefit reimburses up to your plan’s annual amount for a wide range of eligible gear, fees, and services that help keep you moving, indoors and out!

Learn more about all the items and services reimbursable through your Wellness Wallet and how to request a reimbursement below.

 

 

 
NOTE: Vision and Eyewear coverage is now a separate benefit, and is no longer reimbursed under Wellness Wallet.
For information about Vision/Eyewear benefits, visit our Vision Benefits page.
 

Have questions? We’re here to help.
Talk to a Member Service Representative 8:00AM - 8:00PM, Monday to Friday.

Current Members:
1-866-544-7504

Enroll:
1-800-603-0652
(TTY: 711)
Reimbursement forms

How to Use Your Wellness Wallet Benefit 

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STEP ONE:

Check to make sure the item/service you want to purchase qualifies for reimbursement. If you don’t see it on the list below, please call Member Services. Other items used for physical activity may qualify for reimbursement!

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STEP TWO:

Purchase your qualifying items and make a copy of your itemized receipt and proof of payment.

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STEP THREE:

Download the 2023 Wellness Wallet Reimbursement Form for items or services purchased in 2023 or 2022 Wellness Wallet Reimbursement Form for items or services purchased for the rest of 2022 (must be submitted by March 31, 2023).

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STEP FOUR:

Mail completed reimbursement forms with itemized receipts and proof of purchase to:

Martin’s Point Generations Advantage Claims Department
PO Box 11410
Portland, ME 04104-9863 

We’ll process your request and get a check out to you within 4-6 weeks.

 

Reimbursable Amounts by Plan

Your Wellness Wallet reimburses up to your plan’s annual amount for covered items/services.

Reimbursement amounts by plan are as follows:

Plan Name 2022 Maximum Reimbursement Amount 2023 Maximum Reimbursement Amount 
Prime (HMO POS) Up to $400/Year Up to $300/Year
Select (LPPO) Up to $200/Year Up to $300/Year
Alliance (HMO) Up to $450/Year Up to $450/Year
Value Plus (HMO) Up to $300/Year Up to $400/Year
Focus DC (HMO SNP) Up to $450/Year Up to $300/Year

Reimbursable Items and Services

Below you will find a general list of items that are covered by Wellness Wallet, organized by category. Items and services that are not covered by Wellness Wallet can be found under the last tab section.

To inquire about reimbursement of other items, fees, or services not listed below, please contact Generations Advantage Member Services at 1-866-544-7504.
  • Bowling
  • Golf
  • Sports clubs and leagues
  • Skiing
  • Aerobics
  • Personal trainers at fitness facilities
  • Bicycles (standard and power-assist)
  • Bicycle helmets
  • Kayaks and canoes
  • Crampons for footwear (microspikes, Yaktrax, etc.)
  • Ski equipment
  • Walking/hiking poles
  • Wearable fitness tracker (including Apple Watch and other smartwatches)
  • Dance
  • Martial arts
  • Tennis
  • Yoga
  • Online fitness
  • Kayak lessons
  • Ski lessons
  • Workout videos or streaming apps/subscriptions
  • Braces worn while working out (back, wrist, ankle)
  • Reflective safety gear (reflective clothing such as jackets, pants, etc. are not covered)
  • Bicycle repair
  • Exercise equipment repair
  • Personal trainer within the home
  • Cell phones
  • Gift cards
  • Home pools/cleaning services
  • EKGs
  • TENS units
  • Exercise clothing (t-shirts, shorts, etc.)
  • Massage therapy
  • Inversion tables
  • Hypnotherapy and homeopathy
  • Food/meal programs

Wellness Wallet FAQs

Frequently-asked questions relating to the Wellness Wallet benefit.

WHAT ARE THE ACCEPTABLE PROOFS OF PAYMENT?

The proof of payment must indicate what was bought, how much it cost, and how it was paid for. This can be in the form of an itemized register receipt, bank statement, credit card bill, stamped bill, paid statement, or a cancelled check. We do not accept invoices, order / pick up confirmations, or shipping statements with no proof of payment. It is okay for you to use a gift card or gift certificate as the payment method, as long as the receipt indicates the payment method. 


IF I ENROLL IN MY GENERATIONS ADVANTAGE PLAN MID-YEAR, DO I STILL RECEIVE THE ENTIRE WELLNESS WALLET BENEFIT AMOUNT?

Yes! You receive the entire Wellness Wallet amount that is offered under your Generations Advantage plan even if you join the plan mid-year. As a reminder, dates for received services or purchased items must be within the current plan year in order to be reimbursed under that year's Wellness Wallet benefit. (See next FAQ for details on gym memberships.)


CAN I BE REIMBURSED FOR SHIPPING AND/OR ASSEMBLY FEES?

Yes! Under your Wellness Wallet benefit, the costs of taxes, shipping, delivery and assembly can be reimbursed.


WHAT HAPPENS IF I PLACE AN ORDER, BUT MY PAYMENT ISN'T PROCESSED UNTIL A LATER DATE?

If you place an order for an item, but payment is not taken until a later date, the date you placed the order is considered the date of purchase so long as your receipt shows the date you placed the order. For example, if you place an order for an item on 12/31 but payment is not taken from your account until 1/1, your purchase date would be considered 12/31 provided that your receipt lists the 12/31 order date.


CAN A MEMBER USE CREDIT CARD POINTS OR A GIFT CARD TO PURCHASE AN ITEM?

A member can use credit card points or a gift card to purchase an item so long as the receipt shows the cash value of the item.


HOW DO I FIND OUT IF MY WELLNESS WALLET REQUEST HAS BEEN DENIED?

Members receive their notification of Wellness Wallet determination via their Explanation of Benefits. Denial reasons will be listed on the Explanation of Benefits. This means members will receive notification within 30 days after the claim is processed. 

WHERE CAN I PURCHASE FITNESS EQUIPMENT?

You can purchase equipment from any licensed retail establishment. We will not approve reimbursement for fitness equipment that has been purchased from a nonretail source (example: yard sale or Craigslist). The safety of our members is important and we want to ensure there is no risk of injury from noncertified equipment. If members are seeking to save on the costs or prefer to purchase second-hand equipment, there are a number of retailers—such as Play-it-Again Sports—that offer used equipment that has been checked for proper function and safety.


WHAT HAPPENS IF A MEMBER BUYS A FAMILY PLAN GYM MEMBERSHIP?

The membership cost will be split in half and half of the membership will be reimbursed.


WHAT HAPPENS FOR SPOUSES WHO WANT TO SPLIT THE COST OF GYM MEMBERSHIP OR EQUIPMENT BETWEEN TWO WELLNESS WALLET BALANCES?

Spouses have the ability to split family gym memberships or shared equipment. Members cannot split "single use" items or equipment. (For example, a bike can be shared, but an apple watch cannot. A treadmill can be shared, but pair of skis cannot.) When submitting to the wellness wallet, the purchase would be divided in half and applied to each members wellness wallet balance, unless otherwise indicated by dollar amounts written on the form. Advise members to complete one Wellness Wallet form and include BOTH of their information (both member names, both member ID#s, and both member DOBs).


WILL MY WELLNESS WALLET COVER A GYM MEMBERSHIP THAT SPANS INTO THE FOLLOWING YEAR?

If you pay for a gym membership that spans months in 2023 and 2024 (for example, a full year membership from July 2023 through June 2024), you will be reimbursed for the entire amount of the membership, up to your 2023 Wellness Wallet dollar limit. If you are still a member of a plan with the Wellness Wallet benefit in 2024, you may resubmit the remaining amount at that time.


WILL THE WELLNESS WALLET COVER SILVER SNEAKERS® REIMBURSEMENT?

No. However, we cover a number of items and services comparable to SilverSneakers. Classes, fees or memberships are eligible for reimbursement under your Generations Advantage Plan Wellness Wallet benefit. See your individual plan page for your yearly reimbursement amount. 

WILL ANY NUTRITIONAL/DIETARY PROGRAM BE ELIGIBLE FOR REIMBURSEMENT?

Any individual or group education and counseling is eligible for reimbursement, as long as the services are provided by licensed or certified practitioners furnishing services within the scope of their license or certificate.


WILL THE WELLNESS WALLET COVER NUTRISYSTEM® OR OTHER MEAL PROGRAMS?

Per Medicare guidelines, only weight management programs, such as Weight Watchers®—that include weekly structured lessons with regular feedback and monitoring tailored to individual goals qualify. We cannot cover any food for reimbursement.

CAN I USE MY WELLNESS WALLET DOLLARS FOR DENTAL OR DURABLE MEDICAL EQUIPMENT?

Wellness Wallet reimbursement is only for applicable items/services. Durable Medical Equipment/Dental does not fit within the covered categories.


CAN I USE MY WELLNESS WALLET DOLLARS FOR EYEWEAR OR VISION CARE?

Vision services and eyewear coverage has been switched to a standalone, separate benefit. As a result, these expenses are no longer reimbursed under Wellness Wallet.

To access information regarding your Vision/Eyewear benefits, click here.

More Questions about our Wellness Wallet Benefit?

If you are not sure whether your expense is eligible for reimbursement, or have other questions about Wellness Wallet benefits, please call Martin's Point Generations Advantage Member Services.