Insurance coverage for obesity

Weight loss programs that accept health insurance

 Although most weight loss programs are cash only, W8MD medical weight loss centers of America is one of the few physician supervised weight loss programs to accept health insurances.

Insurance coverage for obesity

Obesity has been recognized as a medical condition by the World Health Organization(WHO) since the year 1997 although the American Medical Association only recently recognized obesity as a chronic medical condition.

According to the obesity and overweight data available from the CDC, approximately 2 in 3 of all adults are either overweight or obese and 1 in 3 U.S. adults and 1 in 6 children and adolescents are obese.

Cost of obesity

Obesity has both direct costs related to obesity and over 50 obesity related medical conditions and indirect causes related to loss of up to 10 years of life, loss of productivity etc.

In 2008, medical costs associated with obesity were estimated at $147 billion; the medical costs for people who are obese were $1,429 higher than those of normal weight.

George Washington University study shows the direct annual cost of obesity is a staggering $4879 for a woman and $2646 for a woman. If you add the cost of the loss of years of life due to obesity, taking the average in the economic value of lost life, then the women’s annual obesity costs up to $8,365, and men’s to $6,518.

Obesity’s yearly costs: $4879 for a woman, $2646 for a man

“Obesity: Complex but Conquerable” according to the Institute of Medicine.

Insurance coverage for weight loss

If you have health insurance, and are a bit overweight or obese, you may want to learn about how your insurance might help you in your efforts to shed some pounds! Here are some of the things you might want to know about how your insurance might help you in your weight loss journey!

Although there are both surgical and non-surgical measures to lose weight, for the vast majority of patients, a non-invasive way to lose weight through changes in diet, physical activity with or without appetite suppressants is the first thing to try and therefore, the focus of this article is physician supervised medical weight loss

Affordable Care Act and weight loss insurance coverage

Prior to the passage of the 2010 Affordable Care Act, the coverage for weight loss varied widely and most insurance plans did not adequately cover or excluded obesity coverage. However, this has changed after the passage of the affordable care as obesity is considered a preventable disease and therefore, mandated to be covered by all health insurances including Medicare and private insurances by the Affordable Care Act.

Let us look at the individual insurance plans and their coverage for obesity related services for all major insurances including Medicare, Medicaid, commercial insurances and review the various plans.

Medicare weight loss coverage for obesity

Obesity screening for all adults is covered irrespective of their weight as it is a screening test. If a person is then found to have a body mass index of 30 or more, or have certain weight related medical conditions even with a lower body mass index of 28 or more.

How often is the weight loss counseling covered by Medicare?

Medicare will cover Intensive Behavior Therapy for obesity provided by a qualified licensed physician or other primary

care practitioner in a primary care setting, are eligible for:

• One face-to-face visit every week for the first month;

• One face-to-face visit every other week for months 2-6; and

• One face-to-face visit every month for months 7-12, if the beneficiary meets the 3kg (6.6 lbs) weight loss requirement during the first 6 months.

http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/downloads/MM7641.pdf

Who’s eligible for Medicare weight loss?

All people with Medicare who have a body mass index (BMI) of 30 or more are covered.

Medicaid weight loss coverage for obesity

The Affordable Care Act has several provisions that mandate coverage for obesity-related services and coverage.

These provisions include an enhanced federal match for states to cover obesity screening and counseling for children, adolescents and adults as recommended by the United States Preventive Services Task Force(USPSTF). The law also calls for states to design public awareness campaigns to educate Medicaid enrollees on the availability and coverage of preventive services, including obesity-related services.

Learn more on Medicaid coverage for obesity, check your states medicaid page and the following page for general information on Medicaid coverage for obesity related services.

http://www.medicaid.gov/medicaid-chip-program-information/by-topics/quality-of-care/downloads/rtc-preventive-obesity-related-services2014.pdf

Blue Cross Blue Shield (BCBS) insurance coverage for obesity

Obesity screening for all adults is covered irrespective of their weight as it is a screning test. If a person is then found to have a body mass index of 30 or more, or have certain weight related medical conditions even with a lower body mass indexof 28 or more.

Bariatric surgical coverage and Anthem Blue Cross and Blue Shield

Anthem BCBS does cover preventive services including obesity treatment and counseling and weight loss surgery as long as your policy does not

specifically exclude coverage. Coverage for weight loss surgical options are dependent upon the employer who can choose to opt out of certain costly weight loss options in order to save on insurance premiums. For further information, you may contact Anthem Blue Cross Blue Shield at 1-866-293-2892. You can also locate a contact number and email address on their website.

W8MD's weight loss team

W8MD’s weight loss team

Medical Nutrition Therapy coverage and Blue Cross Blue Shield

Medical Nutrition Therapy and Diabetes Self Management Training are separate benefits with most insurance companies. Anthem may cover for Diabetes Education from a recognized program at a hospital facility or when billed by a participating physician.

Also see

Aetna weight loss coverage

BCBS weight loss coverage

Cigna weight loss coverage

Medicaid and Medicare weight loss coverage

1199 weight loss coverage

GHI emblemhealth weight loss coverage

United Healthcare weight loss

New Jersey

W8MD’s NJ medical weight loss program, sleep and medspa

140 E Evesham Road, Cherry Hill NJ 08003.

Disclaimer: Please note that the information here is general and may not apply to your plan. Call or check with your insurance on your plans coverage.

How can W8MD help?

W8MD’s insurance physician weight loss program is unique in many ways with a comprehensive multidisciplinary approach to weight loss that addresses all the complex issues leading to weight gain, both in adults and children. Since its inception in 2011, W8MD has successfully helped thousands of patients succeed in not only losing weight but also keep it off with an ongoing maintenance plan.

Aetna insurance coverage for obesity

Screening and counseling for obesity is covered as required by the Affordable Care Act.

In addition to the coverage of obesity under preventive services mandated by Affordable Care Act, Aetna and many other private insurances also cover

certain nutritional counseling when provided by a qualified healthcare provider such as a registered dietetician or nutritionist.

http://www.aetna.com/cpb/medical/data/1_99/0049.html

Aetna coverage for medical nutrition therapy

Medical Nutrition Therapy and Diabetes Self Management Training are separate benefits with most insurance companies. Make sure when you call your

insurance company that you specify which benefit you are asking about. Aetna Covers for MNT and DSME with a participating provider after co-

pay/deductible. Check with your individual plan.

CIGNA coverage for obesity

Screening and counseling for obesity is covered by Cigna as required by the Affordable Care Act.

 

Medical Nutrition Therapy and Diabetes Self Management Training are separate benefits with most insurance companies.

Cigna Covers for MNT and DSME with a participating provider after co-pay/deductible. Check with your individual plan.

United Health Care coverage for obesity

Screening and counseling for obesity is covered by United health care as required by the Affordable Care Act. Medical Nutrition Therapy and Diabetes Self Management Training are separate benefits with most insurance companies.

United Health Covers for MNT and DSME with a participating provider after co-pay/deductible. Check with your individual plan.

Tricare insurance coverage for obesity

Screening and counseling for obesity is covered by Tricare as required by the Affordable Care Act.

Medical Nutrition Therapy and Diabetes Self Management Training are separate benefits with most insurance companies.

Tricare will not cover for MNT, even as a secondary plan to Medicare.

AARP insurance coverage for obesity

Screening and counseling for obesity is covered for all adults and children.

Medical Nutrition Therapy and Diabetes Self Management Training are separate benefits with most insurance companies.

AARP will cover as a secondary provider.

Other insurance companies such as 1199, GHI, Multiplan, Keystone 65, Keystone Mercy, Highmark BC/BS Affiliates, Horizon BC/BS Affiliates, Independence BC/BS Affiliates, BRAVO, CIGNA-PA/DE. Fidelis, GREATWEST-One Health Plan of PA, Keystone Health Plan East etc. also have coverage for weight loss depending on your insurance plan. Please check with your insurance carrier for details.

W8MD Weight Loss Program

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