Affordable Care Act: Coverage for Weight Loss

Need to lose weight? You’re not alone. Talk to your doctor. You may be able to get free help through your health care plan* under the Affordable Care Act.

Most health insurance plans, including all plans purchased through the Marketplace, now include obesity screening and counseling, with no copays or deductibles. When you go in for a physical, your doctor will usually check your weight and height. With those numbers, he or she can figure out your body mass index, or BMI. A BMI of 25 or higher is overweight. A BMI of 30 or more is obese.

People who are obese are more likely to get serious health problems such as heart disease, diabetes, and some cancers. Losing weight can lower your chances of getting any of those.

If your doctor finds that you fit the medical guidelines for obesity, you may get counseling sessions on diet and weight reduction. This may include one-on-one meetings, or you may get weight loss advice and support in a group such as Weight Watchers. Check with your insurance plan for more information.

The counseling sessions can help you change any unhealthy eating and exercise habits. That, in turn, can help you lose weight and lower the chance of health problems.

Under the Affordable Care Act, there is no exact definition of what obesity counseling must include. Coverage varies from plan to plan, so call your insurer to see what your policy will cover. If you get insurance through your job, you can also call your human resources department to check.

To help you get back to a healthy weight, your doctor may suggest a diet and exercise program. Most people will want to eat lots of fruits and vegetables, whole grains, and low-fat dairy products. Choose lean meats and foods that are low in unhealthy fats, cholesterol, and added sugars. Exercise helps, too. Work your way up to 30 minutes most days.

If you have a lot of weight to lose, your doctor may suggest medication or surgery. The Affordable Care Act does not require health plans, including those purchased through the Marketplace, to cover this, but some do. Check your plan to see what’s available to you.

 

* Grandfathered health plans, those that existed before the Affordable Care Act was passed and have not significantly changed, are not required to offer weight loss counseling. Check with your insurance company or HR department to find out if you’re in a grandfathered plan. In addition, short-term health plans do not have to offer these benefits. Short-term health policies are those in effect for less than 12 months, although they can be renewed for up to 3 years.

 

WebMD Medical Reference Reviewed by Sarah Goodell on September 13, 2018

Sources

SOURCES:

CDC: "Losing Weight;" "Healthy Eating for a Healthy Weight;" and "Physical Activity for a Healthy Weight."

HealthCare.gov: "What are my preventive care benefits?"

Healthfinder.gov: "Watch your weight."

Medscape: "Getting Paid for Treating Obesity, Now that It's a 'Disease.'"

SurgeonGeneral.gov: "Overweight and Obesity."

U.S. Preventive Services Task Force: "Screening for and Management of Obesity in Adults."

 

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