Does Medicare Cover Weight Loss Programs? If you are considering losing weight, but you're on Medicare, you may be wondering if the plan covers it. Unfortunately, Medicare does not cover weight loss plans for eligible beneficiaries. Under most circumstances, Medicare consider weight loss plans to be elective lifestyle-related programs which are not covered by any part of Original Medicare. Even for those beneficiaries who are eligible for other forms of Medicare coverage, losing weight through diet and exercise programs is not likely to result in coverage cancellation. However, Medicare does cover the cost of some weight-loss medications.
There are several types of weight-loss programs available to Medicare beneficiaries. One type of weight-loss program is known as Medigap Alcohol Weight loss program (MOWP). This type of program reimburses health-care providers for some of the cost of alcohol treatment for a Medicare beneficiary who has an excess amount of weight. The cost of MOWP varies from plan to plan, with some plans requiring a balloon payment and others allowing the provider to make payments month after month until the policy is paid in full. While the majority of Medicare plans do not cover costs of MOWP, some do offer the coverage.
Medicare does cover the cost of some other weight loss programs as well. Medicare does not cover the cost of participating in a fat-burning fitness class, however. Similarly, Medicare does not pay the cost of a personal trainer or gym membership. As with the MOWP program, most Medicare weight-loss programs have a maximum limit on the amount that can be reimbursed.
Some people wonder if they can use their Medicare Advantage Plans to pay for their own personal fitness activities. The answer is that yes, you can. If you meet the healthiest criteria for enrollment into a Medicare Part A or Part B program, you may be eligible for enrollment into an inpatient rehab facility. In order to find out if you meet the benefit eligibility requirements, call your local Medicare representative.
For individuals who do qualify for inpatient care, there are several options available for those who need extra help. One is the Medicare Waiver Program, which allows eligible patients to receive additional Medicare payouts for additional services. Two other options are inpatient weight loss services provided by certified nursing-home facilities and outpatient weight loss services.
Some Medicare beneficiaries are also covered for the Medicare Part A prescription drug benefit. That's because they qualify for Part A Medicare, regardless of their health status. With that kind of coverage, whether or not you qualify for additional Medicare coverage depends on your specific medications, as well as your current medical condition. Speak with your medicare representative to learn more about additional Medicare coverage for dietitians and other medically necessary weight loss programs.
If you're interested in pursuing further Medicare coverage for dietitians and other medically necessary weight loss services, talk to your representative. There are typically two options: standard benefits or regionalized benefits. Standard benefits are available to all Americans regardless of health status. However, if you reside in one of the seven Medicare regions - territories included - where the regional Medicare provider doesn't offer inpatient weight loss services, you'll have access to regionalized Medicare coverage.
Whether you've just lost some weight, or would like to maintain your current weight, enrolling in a weight loss program is an excellent way to ensure that you'll be able to achieve your ideal weight. Your regular doctor will be able to provide you with the information you need to understand whether your particular situation qualifies under your Medicare policy. In most cases, you will also be able to find supplemental coverage - usually at a higher deductible - through your regular Medicare supplier.
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