Are Obesity Diet Plans Covered by Insurance?

 Effects of Obesity, Obesity  No Responses »
Dec 102011
 

Are Obesity Diet Plans Covered by Insurance? The answer is it depends. If your doctor prescribes our Obesity Diet Plan due to health conditions, usually that you are morbidly obese or have other obesity related systems like Type 2 diabetes, heart disease or severe apnea and remain under your doctor’s supervision during the program or as a pre-diet consulting to lap-band surgery. Call your insurance company and explain the situation and ask, it is a cheaper option that lap band surgery.

Run-of-the-mill weight-loss programs aren’t covered by most insurance policies, according to the National Institutes of Health, but your insurer may cover prescription weight-control medications and weight-loss surgery.

The latter typically costs $25,000 to $30,000, so coverage is a really big deal. To qualify, though, you have to be morbidly obese — 80 pounds or more overweight for women, 100 pounds or more for men. You may also qualify if you’re not quite that heavy but you have a serious weight-related condition, such as Type 2 diabetes, heart disease or severe apnea.

Even if your weight-loss program isn’t covered by insurance, you may still be able to defray the cost if it’s prescribed by a doctor. In that case, you can use the pretax money you’ve put in your flexible-spending account at work to pay for it. Flexible-spending plans allow you to pay for a host of other medical expenses that may not be covered by insurance, including smoking-cessation programs, birth control, fertility treatments, orthodontia and over-the-counter medications, including aspirin. Oh, yes, and doctor-prescribed massage.

Update: Medicare Will Pay for Obesity Counseling 

Medicare to cover obesity counseling, screening

 Medicare / Medicaid / SCHIP  No Responses »
Nov 302011
 

(Reuters) – The U.S. Medicare program for the elderly will cover counseling for obesity in an effort to reduce the condition that has reached epidemic proportions and leads to serious health problems. 

The Centers for Medicare & Medicaid Services (CMS) said on Tuesday obesity counseling and screening has been added to its portfolio of preventive services.

“Prevention is crucial for the management and elimination of obesity in our country,” CMS Administrator Donald Berwick said in a statement.

More than 30 percent of both men and women in the Medicare population are estimated to be obese, CMS said.

Obesity can lead to a host of health problems and complications and is a leading cause of diabetes and heart disease.

Screening for obesity and counseling for eligible beneficiaries by primary care providers are covered under the new benefit, CMS said.

For patients deemed to be obese based on body mass index measures, 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.

Medicare patients who lose at least 6.6 pounds (3 kilograms) during the first six months of counseling would be eligible to receive addition face-to-face counseling once a month for an additional six months for up to a total of 12 months of counseling, the agency said.

“This decision is an important step in aligning Medicare’s portfolio of preventive services with evidence and addressing risk factors for disease,” Patrick Conway, the CMS chief medical officer, said in a statement.