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Does Medicare Cover Weight Management Needs?

"Does Medicare Cover Weight Management Needs?" text over image of senior citizen standing on scale

Will Medicare cover the weight management services that you need? Our licensed agents will be happy to answer any questions you may have about Medicare coverage for weight management services. Give us a call today at (800) 950-0608.

Just the Essentials:

  • Medicare covers obesity screenings as a preventative measure to assist with medical weight management.

  • Medical nutrition therapy and obesity behavioral therapy are covered by Medicare as well.

  • Medicare may cover bariatric surgery if it is considered to be medically necessary.

  • Medicare Advantage plans may help cover gym memberships, fitness program subscriptions, and, for a limited time, healthy meal delivery.

Keep An Eye on Your Weight to Ensure Your Golden Years Stay Healthy!

Obesity has become a major epidemic over the last few years. Today, this serious health condition affects 42 percent of adults in the United States. If you’re a senior suffering from obesity, it can drastically lower your quality of life. If you’re overweight or obese, joining a weight loss program can greatly improve your health and well-being.

The downside is that weight loss programs can be costly. Some can cost up to hundreds of dollars per year, or in certain instances, per month. This puts them out of reach for seniors living on a fixed income.

What if you’re a Medicare beneficiary, though? Does Medicare cover weight loss programs?

At MedicareInsurance.com, it’s our mission to make sure that you know what Medicare plans may or may not cover. Medical weight management programs do a great deal of good for seniors who struggle with obesity on a daily basis. Today, we’re going to take a look at the types of weight management and weight loss programs that may be covered by your Medicare plan.

Your Medicare Plan May Cover Obesity Screenings and Counseling

In many cases, proper education geared toward healthy eating habits and exercise can be enough to help you get your weight under control. Most doctors today offer medical weight management programs that are centered around medical nutrition therapy and obesity counseling. If you’re enrolled in a Medicare plan, it covers these services if you meet certain requirements.

Before you can receive any type of counseling for weight loss, you’ll need to undergo an obesity screening. Whether or not you’ll be covered completely for weight management and nutrition therapy depends on two factors:

  • Having a body mass index (BMI) score of 30 or more.
  • Whether or not your primary care practitioner accepts Medicare assignment.

If these qualifications are met, then you’ll pay nothing for basic weight management services. Medicare Part B, the medical portion of Original Medicare, will cover:

  • Your initial obesity screening.
  • A dietary assessment.
  • Behavioral therapy sessions for medical weight management.

For those suffering from diabetes or kidney disease, Medicare Part B may also cover the following weight management and nutrition therapy services at no cost:

  • A nutrition and lifestyle assessment.
  • Individual and/or group nutritional therapy services.
  • Counseling on managing lifestyle factors that affect diabetes.
  • Follow-up visits to check on dietary progress.

It’s important to know that Medicare Part B may not completely cover certain weight management services. For instance, your primary care physician may feel that you need these services more often than Medicare will cover them. They may also recommend weight management or weight loss services not covered by Medicare. To avoid tackling extra costs, be sure to ask your PCP why they’re recommending these services, as well as whether Medicare will pay for them or not.

Will Medicare Cover Weight Loss Surgery?

In extreme cases, weight loss surgery may be the best way to help you get your weight under control. If you’re in this boat, you may be wondering whether or not Medicare will cover weight loss surgery. The good news is that Medicare will cover a few different types of weight loss surgery. However, your physician must deem the procedure to be medically necessary. 

Whether your procedure is done inpatient or outpatient, Original Medicare (Medicare Part A and Medicare Part B) will cover the following types of weight loss surgery:

Before Medicare will cover your weight loss surgery, you’ll need to meet certain requirements. In order to receive Medicare weight loss surgery coverage, the following must pertain to you:

  • BMI must be 35 or higher.
  • You have at least one obesity-related comorbidity (Type 2 Diabetes, heart disease, etc.).
  • Other medical treatments for weight management, including weight loss programs, have been unsuccessful.

If you choose to undergo weight loss surgery, it’s important to understand that the procedure is not a “cure-all”. You’ll still need to be able to make proper behavioral and lifestyle changes after your operation for the procedure to work as intended. For this reason, it’s still a great idea to take advantage of the therapeutic weight management services that are covered by Medicare before and after having weight loss surgery.

Medicare Advantage May Cover Weight Management Programs and Services That Original Medicare Does Not

Let’s say you’re looking for help with a few other services that can make a positive difference in your weight loss journey. For instance, you’re wanting to join a local gym, but you can’t afford the cost on your own. Original Medicare cannot help you cover these services, unfortunately, but that doesn’t mean finding coverage is a lost cause.

Certain Medicare Advantage plans may cover weight management services that Original Medicare does not. A number of Medicare Advantage plans provide memberships to SilverSneakers, as well as other weight management and wellness programs. They may also help cover membership fees for certain known gym chains.

A Good Medicare Plan Can Help Make Your Weight Loss Journey Easier

Proper weight management is important for individuals of any age. For seniors, it’s incredibly crucial. The medical issues linked to obesity that give younger individuals a tough time can be downright debilitating for older adults.

Weight management and weight loss programs can be expensive, it’s true. However, they aren’t out of your reach. With a Medicare plan, you can find adequate coverage that’ll help you meet your weight loss goals at little or no cost. From behavioral therapy to bariatric surgery, your Medicare plan can make your own personal weight loss journey a lot easier – and more affordable!

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