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Medicare weight loss

  • Are you one of the over two thirds of all Americans that are either overweight or obese?
  • Do you have Medicare, or Medicaid health insurance and want to know if they cover weight loss doctor visits?
  • Did you know that Medicare, Medicaid and all private insurances are mandated to cover preventive services including weight?
  • If you answered yes to any of the above questions, you are at the right place.

How common is obesity in the US?

According to the CDC, in 2015-2016, about 39% or over two thirds of the US adult population are overweight or obese.

Losing weight

Losing weight

What are the risks of being overweight or obese?

Being overweight or obese increases the risk of type 2 diabetes, heart disease, stroke, gall bladder disease, osteoarthritis, sleep apnea, respiratory problems, and colon, breast, endometrial, and prostate cancers. Other health consequences include compromised psychological well-being along with social stigmatization and discrimination.

Medicare and Medicaid Coverage for Weight Loss

Since the passage of the 201o Affordable Care Act, Medicare and by extension, state medicaid program

s, as well as private health insurances are mandated to provide coverage for weight loss physician visits under preventive care.

 

Since the passage of the 201o Affordable Care Act, Medicare and by extension, state medicaid program

Does Medicare and Medicaid cover weight loss medications?

No. Weight loss medications are an exclusion for Medicare and by extension Medicaid as weight loss medications were not included in the social security act when they passed it long time ago. At that time, weight loss medications were considered cosmetic and were excluded.

Apart from the weight loss physician visits, does Medicare and Medicaid, also cover obesity counseling?

Yes. Medicare approved Intensive Behavior Therapy for obesity weekly for the first 1 month for 15-30 minutes, and thereafter, biweekly for 15 minutes provided by a qualified health care provider following certain guidelines.

How much weight loss is considered the minimum amount after the first 6 months by Medicare?

Medicare requires a minimum weight loss of about 3 kilograms or 6.6 pounds in the first 6 months for it to continue covering the obesity counseling and treatment.

What percent of the Medicare population are considered overweight or obese?

Over 30% of both men and women in the Medicare population are estimated to be obese.

What are the risks associated with being overweight or obese?

Obesity is directly or indirectly associated with many chronic diseases, including those that disproportionately affect racial and ethnic minorities such as cardiovascular disease and diabetes. Medicare realizes that addressing the prevention of obesity related disparities has the potential to reduce obesity prevalence while also closing the gap on health disparities among Medicare beneficiaries.

Who can screen and treat obesity for Medicare and Medicaid?

Although screening for obesity and counseling for eligible beneficiaries by primary care providers in settings such as physicians’ offices, unfortunately, our primary care physicians are over burdened and under trained in dealing with chronic non-urgent medical problems such as obesity.

Did you know that up to 94% of all health care providers in the US receive little or no education in Nutrition?

Realizing the need to have physicians that are trained, experienced and focused on treating obesity, W8MD’s insurance physician weight loss program is a pioneer in the nation to help Medicare, Medicaid and other private health insurance patients lose weight safely under careful medical supervision using evidence based, clinically proven measures.

What are the BMI requirements for a Medicare or Medicaid patient to get coverage for obesity?

For a beneficiary who screens positive for obesity with a body mass index (BMI) ≥ 30 kg/m2, the benefit would include one face-to-face counseling visit each week for one month and one face-to-face counseling visit every other week for an additional five months. The beneficiary may receive one face-to-face counseling visit every month for an additional six months (for a total of 12 months of counseling) if he or she has achieved a weight reduction of at least 6.6 pounds (or 3 kilograms) during the first six months of counseling.

W8MD Team

W8MD Team

How can W8MD’s insurance weight loss program help me if I have Medicare or Medicaid in New York, New Jersey or Pennsylvania?

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.

What additional costs do I incur if I try W8MD’s physician weight loss program with Medicare or Medicaid?

While we accept insurance for weight loss physician visits, since Medicare and Medicaid exclude weight loss medication coverage, our minimal administrative cost of $50.00 biweekly will cover up to two diet medications if dispensed in office.

Medicare and Medicaid weight loss coverage related questions

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