I contacted Bruce Friedland in public relations for the IRS to see what the agency thinks of Novak's claims, and Friedland replied via email that the only reason you're allowed to expense a gym membership (with a prescription, of course) is if it's for "the cure, mitigation, treatment or prevention of a specified disease or for the sole purpose of affecting the structure or function of the body." (That second part seems open to interpretation.)
Friedland was explicit that general health maintenance doesn't qualify.
What insurers say
Lindsey Minella, who works for Humana, told me the insurer follows the IRS guidelines in "Publication 502." (This answer came from Humana Vice President Dr. Fred Tolin.) She said you can't claim a gym membership even with a doctor's note.
But I received a different answer from Aetna. Communications director Anjie Coplin pointed me to a section of Aetna's policy stating that you can claim a gym membership, "When recommended by a health care professional for a medical condition …"
Information on the websites of other insurers or pretax heath-account companies — AsiFlex, Medcom, Cigna, WageWorks, Fsafeds — showed you can claim your gym membership with a doctor's note to treat a medical condition. Cigna qualified that using it for weight loss didn't count, even with a doctor's note, but that may change with obesity recently being labeled a disease by the American Medical Association.
Again, general health maintenance doesn't qualify. So your doctor has to be specific (think diagnostic code).
Mulvagh thinks gym memberships should qualify for FSAs, HSAs and tax deductions. "I think we should be using carrots instead of sticks," she said. "The government has a role to play to promote healthy living. We could cut more than half our health care costs if everyone led healthy lives."
(That is, of course, if people actually show up to the gym to work out and reap the benefits.)
Health Care Services Corporation, which operates Blue Cross Blue Shield, sees profit in being progressive on this issue. Its members have access to 7,000 fitness centers across the U.S. for only $25 a month.
"We see a tangible value in it," said Tom Meier, vice president of product development for Health Care Services Corporation. "The costs of health care depend considerably on lifestyle choices. Members with just one core condition like Type 2 diabetes, cardiovascular disease or obesity can end up costing 21/2 times more in health care."
It's not entirely capitalistic thinking, as Meier asserts his company is passionate about wellness.
"Everything we're doing is designed around helping our members get and stay healthy," he said. It's just a bonus that, "It's been a really big money-maker for us. We've found that our fitness program is showing an 11 percent reduction in health care costs for those who utilize it."
And, after all, Meier explained that fit workers are good for employers as well, as it reduces sick days and boosts productivity.
Fell is a certified strength and conditioning specialist and founder of sixpackabs.com.