There’s new hope for heavy people desperate to lose weight. Many insurers are stepping up their coverage of obesity. Some insurance companies have helped obese patients fight fat for years. They’ve offered weight-loss and wellness programs at businesses, schools and in communities. Some have paid for prescription obesity medications and even covered expensive bariatric surgeries, including gastric bypass.
But now most insurance plans are required to help obese patients try to lose weight under President Obama’s health care law. Exactly how they do it is up to the individual plans. Screening and counseling for obesity has to be covered with no patient cost-sharing (co-payments, co-insurance or deductibles) by most insurers under the preventive services benefit of the Affordable Care Act, says Susan Pisano, a spokeswoman for America’s Health Insurance Plans, the national trade association representing the health insurance industry. Medicare is already covering this service.
It’s a part of the law that many plans have put into action already and more will continue to add by January of 2014. Under a provision of the law, some grandfathered plans don’t have to cover obesity screening and treatment if they haven’t changed their overall coverage since 2010 when the law was passed. So, for the plans that have to cover obesity, if a health care provider screens a patient’s BMI (body mass index, a number that takes into account height and weight) and determines that the patient is obese, then the provider may offer initial weight-loss guidance and refer the patient to a professional service.
Plans vary widely in what they will do. Some insurers are offering telephone counseling; others cover visits with a health coach, and some cover group sessions that offer lifestyle advice. Some are even referring patients to Weight Watchers. Insurance coverage for the treatment of obesity was back in the headlines recently when the American Medical Association, the nation’s largest physician organization, decided to recognize obesity as a disease that requires a range of medical interventions for treatment and prevention. Previously it referred to obesity as “a major public health problem.”