Health Insurance and Weight Loss

Although there is a definite correlation between some diseases and obesity, a person who is overweight is not destined to have these problems. Because little attention has been placed on providing insurance benefits for preventative services, most items covered by insurance were to treat the symptoms of comorbidities rather than the cause.

This approach changed in 2013 when obesity was classified as a disease by the American Medical Association, which ushered in a new way of thinking about care, treatment, and insurance options for people who are overweight. The AMA’s classification enabled providers and patients to use their insurance for weight loss services before more serious health problems arise.

Although providers could typically bill for only big-ticket medical weight loss options (like bariatric surgery), more behavioral health and educational resources are becoming included in insurance plans. Starting small – focusing medical attention on prevention or early attention to weight gain – can reap huge rewards for your health: The American Diabetes Association recommends losing just 5-10lbs to lower your risk of Type II diabetes.

With the AMA’s new classification, there are far more opportunities to bill weight loss services to your insurance. Drug-free, non-surgical options are generally regarded as the first course of action for weight loss. If you’re looking for these services, a great starting place is being enrolled in a Flexible Savings Account (FSA) or Health Savings Account (HSA). Although there are slight differences between both, both FSAs and HSAs are pre-tax benefit accounts that can be used for health-related expenses, including weight loss programs.

Per the IRS, weight loss programs “can be included in your medical expense deduction [if] the weight loss is a treatment for a specific disease diagnosed by a physician (such as obesity, hypertension, or heart disease).”

Since all insurance plans are different, you’ll have to get in contact with your provider about what services may be included in your plan. Some common billable items are:

• Nutritional counseling with a registered dietician or nutritionist
• Nutritional counseling with a Certified Health Education Specialist
• Body composition analysis (including Bioelectric Impedance Analysis)

Focusing on helping people lose excess weight rather than treating only the negative side effects is hugely helpful for insurance companies, health care providers, policy advocates, and patients.