2025 Fitness & Wellness Insurance Guide
by Brian O’Connell
The U.S. health and wellness market is alive and thriving in 2025, as Americans are willing to spend the cash needed to be sound in mind and body.
Whether that means using artificial intelligence to improve exercises and diets, taking diabetes-fighting drugs to lose weight, or joining a running club to build camaraderie with other fitness buffs, the market for health and wellness has exploded. This has led to better lifestyle outcomes and demand for insurance options to cover unexpected and familiar issues.
Those issues come at a time when fitness is ascending. According to Technavio, the worldwide health and wellness market is pegged to grow by USD $2.06 trillion between 2025 and 2029, with a 7.1% compound annual growth rate.
“The health and wellness sector is growing significantly, with major insurers shifting toward newer solutions like digital fitness benefits,” said Andrew Lokenauth, a financial analyst and founder at The Finance Newsletter. Companies are throwing money at things like Peloton memberships and Mirror subscriptions.”
That’s leading to employers getting more creative with health insurance. In late 2024, for example, Lokenauth helped negotiate a deal where his firm got 40% off bulk corporate gym memberships for clients. “The return on investment has been fantastic—we’re seeing about a 25% reduction in sick days and higher employee satisfaction scores,” he noted.
With consumers increasingly in command, how does insurance coverage fit into the burgeoning health and fitness market? Here’s an inside look at 2025.
Employer-sponsored coverage.
2025 is witnessing a significant rise in employer-sponsored wellness programs.
According to a Mercer study, more companies offer health and wellness coverage at historically high price points. The survey of 1,800 companies showed that total health benefit cost per employee is expected to rise 5.8% on average in 2025, “even after accounting for planned cost-reduction measures.”
A separate, late 2024 Mercer study concluded that the average per-employee cost of employer-sponsored health insurance reached $16,501 in 2024 and would rise moderately in 2025.
“Employers doubled down on strategies to manage cost growth while finding ways to improve key benefits to support employees and their families in 2024, including expanded coverage for GLP-1 medications and fertility treatments,” said Mercer’s US health leader Ed Lehman.
The study also noted that the fastest-growing component of health benefit costs continues to be prescription drugs. “Pharmacy benefit cost rose 7.7% in 2024, following an increase of 8.4% in 2023,” the report noted. “One driver of this spend is the growing utilization of GLP-1 drugs for diabetes and weight loss.”
In 2025, employer-sponsored wellness and fitness programs are also evolving to meet the diverse needs of their workforce. “Traditional benefits like gym memberships are being replaced or supplemented by more flexible wellness stipends, allowing employees to choose services that best fit their individual,” said Trista Best, a registered dietitian at The Candida Diet and a long-time public health specialist.
Best said that employers are increasingly covering amenities such as gym memberships, fitness apps, and physical therapy. “That reflects a commitment to comprehensive employee well-being,” she noted. “These initiatives not only promote healthier lifestyles but also contribute to increased productivity and job satisfaction.”
Deciding what’s medically necessary versus cosmetic and personal care.
In an evolving and growing health and wellness market, insurers are differentiating between medically necessary care and what consumers may deem “optional” care.
“Insurers generally follow FDA guidelines and clinical standards to draw the line,” said Mike Jafar, founder and CEO of JOYA, a skin health and wellness benefit company in Newport Beach, Cal. “If a treatment directly addresses a health condition (like obesity-related comorbidities), it’s more likely to be deemed medically necessary.”
Jafar’s company offers a hybrid benefit to employers and employees that includes preventative dermatology care (like skin cancer screenings) and access to high-demand aesthetic services. “This gives employees flexibility without requiring employers to underwrite the cost,” Jafar said.
Coverage for Fitness-Related Injuries
Accidents during workouts constitute a significant coverage gap for many Americans, further driving demand for fitness-related injury coverage. Industry data show workout injuries can lead to huge costs, including medical expenses, lost productivity, and robust legal fees. The average cost of a workplace injury claim is around $40,000.
Key injury coverage areas include accidental medical expense, which covers medical bills for ER calls, diagnostic exams, and sport-related injury surgery. Additional coverage exists for accidental death and dismemberment, which offer cash compensation for sports injury-related death or loss of sight or hearing.
While employer-sponsored plans may cover work-related injuries, injuries sustained during personal fitness activities are usually covered under traditional health insurance—but not always. “Some insurers offer sports injury riders, and certain supplemental accident insurance policies can help bridge the gap,” said Kalim Khan, a co-founder at Affinity Law, an insurance litigation and corporate law firm in Toronto, Canada. “However, many fitness enthusiasts don’t realize they may be personally liable for medical costs if they get hurt in a gym that requires a waiver.”
Treatment options have changed, too. Traditionally, fitness-related injuries have been treated through physical therapy, rest, or surgery—and most are covered under standard health insurance plans. “But in 2025, we’re seeing a growing interest in regenerative treatments like platelet-rich plasma (PRP) injections, laser therapy, and even stem cell options to accelerate healing and reduce downtime,” Jafar said.
These treatments—especially PRP—are gaining traction for injuries like tendonitis, joint pain, and soft tissue damage, particularly among active employees and athletes. “While many of these therapies are still considered elective and not fully covered, there’s a growing push to include them under supplemental or voluntary benefits,” Jafar said. “As demand increases, we anticipate more employers and insurance carriers exploring how to offer access to these cutting-edge therapies as part of a holistic wellness strategy.”
Weight loss drug coverage
Weight loss drugs like Ozempic and Wegovy remain a hot-button issue in 2025, with the more popular drugs costing around $1,300 per month out of pocket.
Insurers are increasingly curbing coverage of such drugs, with industry coverage of Ozempic down 2% from 2024 to 2025 according to GoodRx’s analyses in partnership with Managed Markets Insight and Technology. In sheer numbers, that translates into 1.1 million individuals who no longer have weight loss drug coverage.
Increasingly, employer health plans cover weight loss drugs under specific conditions, typically requiring a BMI threshold and a doctor’s prescription. “The challenge is the sheer cost—these drugs can run thousands of dollars per year per employee, making insurers hesitant to provide blanket coverage,” Khan said. “The key debate is whether obesity treatment is a medical necessity or a lifestyle choice, and insurers tend to draw the line when weight loss is primarily for cosmetic reasons rather than metabolic health concerns.”
Medicaid & Medicare coverage for wellness and fitness
Medicare Advantage plans have led the way in covering gym memberships through programs like SilverSneakers. However, standard Medicare still doesn’t broadly include traditional health and wellness engagements like gym memberships and dieting programs.
“Medicaid coverage varies by state, with some states expanding access to wellness programs and others lagging,” Kahn said. “Weight loss drugs continue into a gray area—some state Medicaid programs cover them, but access is inconsistent.”
Health professionals say that a lack of clarity and transparency is a problem.
“Health insurance often overlooks preventive care, which can lead to chronic illnesses, and a better understanding of medical methods and procedures will guide insurance structures to emphasize proactive health maintenance,” said Dr. Edward Espinosa, a physician and owner at OptumMD in Atlanta, Ga.
Espinosa noted that as preventive care is crucial in mitigating chronic health conditions, private insurers and Medicaid should focus on early intervention. “That means insurance plans are likely to become more tailored around these strategies,” he noted. “Incorporating diverse wellness elements can lead to more effective insurance coverage that truly supports overall health improvement.”
Has inflation impacted the fitness and insurance space?
There’s no doubt that historically high inflation has impacted the health and wellness insurance market, as higher healthcare costs mean employers have to become even more strategic. “There’s pressure to offer high-impact, low-cost benefits,” Jafar said.
Currently, premium increases are averaging 8% this year for wellness programs. “It’s hitting hard,” Lokenauth said. “I’ve had to help several clients restructure their benefits packages, shifting from full coverage to partial reimbursement models. The smart companies offset costs by negotiating bulk rates with virtual fitness providers.”
Impact of U.S. Health Secretary Robert Kennedy, Jr. on fitness and wellness insurance
It’s no secret that Robert F. Kennedy Jr. has been a vocal critic of pharmaceutical companies and mainstream medical policies, which raises uncertainty about how his tenure might impact wellness insurance.
“If his stance leads to a push for alternative medicine coverage, we may see a shift in how insurers approach things like holistic wellness treatments,” Kahn said. “However, regulatory changes take time so that immediate impacts may be limited.”
Major Takeaways For 2025
2025 looks like a year of change, new consumer demands, and high costs for US insurers adapting to the changing healthcare landscape.
“Mental wellness is becoming huge in insurance packages,” Lokenauth noted. “I’m seeing much more meditation app coverage and stress management programs bundled with traditional fitness benefits. There’s also this interesting trend toward personalized wellness incentives — companies using wearable data to adjust premiums.”
Digital therapeutics are the next big thing. “We’ve got three major carriers piloting programs that combine fitness tracking with prescription management, and the preliminary data shows about 22% better adherence rates,” Lokenauth noted.
Another under-the-surface issue is smaller companies joining together to negotiate better wellness program rates. Lokenauth said he helped create a consortium of 50-plus small businesses that got enterprise-level pricing for their wellness benefits. “We saved them each about $150 per employee annually,” he noted.
Additionally, the healthcare market is finally showing signs of shifting toward prevention.
“These aren’t just feel-good programs anymore — they’re becoming core to managing healthcare costs,” Lokenauth added. For insurers, one problem going forward is that measuring return on investment remains tricky. “You really need 3-5 years of data to see the full impact,” Lokenauth said.
