When it Comes to Weight Loss, Do You Know What Your Insurance Will Pay For?


You’ve tried everything, from latest fad diet to the most strenuous exercise classes, but nothing seems to work. Losing weight is tough, and for some people, surgery may be the best option. Of course, surgery can cost quite a bit of cash, but don’t fret. Insurance may pay for it. Here’s your guide to what your insurance may and may not pay for when it comes to obesity.

When the 2012 Affordable Care Act was passed into law by President Obama, obesity became a form of disease that is now covered under some insurances. According to the National Conference of State Legislatures (NCSL), the two most common types of coverage insurance companies offer for obesity are bariatric surgery and nutritional counseling and therapy. 

Bariatric surgery

Bariatric surgery coverage is required in most policies in 30 states, including Arizona, California, New York, Rhode Island and Vermont. Bariatric surgery is a procedure that, according to the NCSL, “reduces the physical size of a patient’s stomach and the urge to over-eat.” If you’ve been struggling with weight loss and can’t find a solution, speak with a doctor about the possibility of surgery. Check with you insurance company to see if you are eligible for benefits.

Nutritional counseling

In addition to bariatric surgery benefits, 16 states “now include some coverage and reimbursement for dietary or nutritional screening, counseling and/or therapy for obesity, sometimes including weight loss programs,” according to the NCSL. These can be great ways to help control your weight and speak with others about just what you can do to help you lose the weight and keep it off. Other states, like Florida, Oklahoma and Washington, also include nutritional screening and therapy, but only for those affected with diabetes. Dietary guidance from home health workers, medically-necessary weight management drugs, dietitian visits, blood pressure screenings, and cholesterol screenings are also available in some states. 

The NCSL also notes that there are:

  • No consumer cost- sharing. Most insurance plans in all 50 states are required to cover certain services with no cost-sharing, including obesity screening and counseling for all adults and children. This includes no annual deductible amount, no enrollee copayments or coinsurance.
  • Premium surcharges for being obese are prohibited in most insurance policies in all 50 states, including those sold through exchanges.

You’re not alone

Always check with your insurance company and speak to a doctor if you need help losing pounds. In America, more than one-third of adults are obese. You’re not alone if you’re struggling with weight loss. There are plenty of options available beyond surgery and therapy.

PublicHealth, an organization that is dedicated to connecting adults to the latest healthcare issues and news, writes that there are a few factors driving obesity in the US: large portion sizes (lay off the heavy meat intake and fast food), a confusion between dieting and nutrition (just because it says “fat free” doesn’t necessarily mean it’s good for you), and inactivity (start walking if you want to burn those calories – sitting in front of the computer or television isn’t going to help you!). Stress, poor sleep, and smoking also contribute to weight gain.

Speak to a doctor for your best options – whether it’s a new diet, a new exercise regime, or something as drastic as surgery or drugs, there are options for you, and your insurance might actually cover you.