Is obesity covered by insurance?

Asked by: Rosina Schmeler  |  Last update: October 22, 2025
Score: 4.6/5 (33 votes)

The Affordable Care Act requires most health insurers to cover obesity screening and counseling. These services are considered preventive care for adults and children. Diet counseling is also available for adults at higher risk for chronic conditions.

What qualifies as medically obese?

Overweight and obesity are defined as abnormal or excessive fat accumulation that presents a risk to health. A body mass index (BMI) over 25 is considered overweight, and over 30 is obese.

Can insurance deny you for being overweight?

Under the Affordable Care Act, as of 2014, group and individual health plans will no longer be able to charge different premiums or deny coverage based on obesity or health status.

How can I get my insurance to approve weight loss medication?

How to get insurance to cover weight-loss medication
  1. Read your policy. Review the details of your health insurance plan. ...
  2. Gather information from your healthcare professionals. ...
  3. Get prior authorization. ...
  4. Write a letter advocating for coverage. ...
  5. Write an appeal if you're denied coverage.

What qualifies you for weight loss medication?

When should you start considering a weight loss medication?
  • BMI equal or greater than 30.
  • BMI equal or greater than 27 with one or more obesity-related conditions (like high blood pressure or diabetes)
  • Have not lost at least 5% of their total body weight in three to six months with lifestyle changes alone.

Is Gastric Bypass Covered by Insurance? | Obesity

37 related questions found

How much do you have to weigh to be prescribed weight loss pills?

These medications may be prescribed to treat overweight or obesity in adults with a BMI of 30 or greater, or with a BMI of 27 or greater if you have weight-related health problems such as high blood pressure or type 2 diabetes.

How to lose 50 pounds in 3 months?

Steps
  1. Eat fewer calories than your body needs to lose weight. ...
  2. Eat smaller meals more frequently. ...
  3. Include more protein in your diet. ...
  4. Increase your fiber intake. ...
  5. Drink plenty of water to stay hydrated and boost your metabolism. ...
  6. Cut out alcohol and sugary drinks. ...
  7. Add more whole foods to your diet and avoid processed foods.

What insurance covers weight loss?

Many PPO insurance providers are now providing coverage for Gastric Sleeve, Gastric Bypass, Distal Bypass and Lap-Band Removal. Aetna, Anthem Blue Cross Blue Shield, Cigna, Oscar, Tricare and United Health Care typically cover weight loss procedures.

What is the strongest weight loss prescription pill?

Some of the strongest weight loss pills available today include: Naltrexone/bupropion (brand name Contrave) Phentermine/topiramate (brand name Qsymia) Orlistat (brand names Xenical, Alli)

Can you really get Wegovy for $25?

Yes, you can really get Wegovy for $25 if you meet certain criteria. Offered by Novo Nordisk, the Wegovy Savings Card awards qualified individuals the opportunity to get the medication for $25 per month (i.e. 28-day supply).

Why is obesity not covered by insurance?

Very few states ensure coverage of recommended treatments for adult and pediatric obesity through Medicaid or private insurance. Most states allow obesity to be used to adjust rates in the small-group and individual markets and to deny coverage in the individual market.

How much do weight loss injections cost?

How Much Do Weight Loss Injections Cost? There are several types of weight loss injections, and even some sublingual forms of medication. On average, weight loss injections can cost between $1,000 and $1,400 per month.

At what point is obesity a disability?

The vast majority of courts have held that obesity is not a disability under the ADA unless it is caused by an underlying health condition. Some federal district courts, as well as many state courts, have held that obesity is a disability even absent evidence of an underlying health condition.

What are the 4 types of obesity?

Four phenotypes of obesity have been described, based on body fat composition and distribution: (1) normal weight obese; (2) metabolically obese normal weight; (3) metabolically healthy obese; and (4) metabolically unhealthy obese. Sarcopenic obesity has been characterized, related to all the described phenotypes.

Is 300 pounds morbidly obese?

There are several medically accepted criteria for defining morbid obesity. You are likely morbidly obese if you are: more than 100 lbs.

What pills did Kelly Clarkson take to lose weight?

She confirmed the rumors during a May episode of "The Kelly Clarkson Show" when chatting with Whoopi Goldberg, who's also been open about using Mounjaro, another weight-loss drug.

How to lose 20 pounds in a month?

Losing 20 pounds in 1 month may be easier than 2 weeks, but it's still unrealistic for most people. Once again, it comes down to your TDEE and simple math. To lose 20 pounds in 1 month, you'd need to create an average deficit of 2,500 calories per day for 4 weeks. This might be possible for larger men.

Is Ozempic covered by insurance?

Most insurance companies cover Ozempic when it's prescribed to treat type 2 diabetes, but not for weight-loss. Ozempic use for weight loss is considered “off-label” and is not approved by the FDA. Insurance companies may not pay for “off-label” or unapproved uses of drugs.

How much do you have to weigh for insurance to cover weight loss surgery?

Have a body mass index (BMI) of 35 or higher, or have a BMI between 30 and 35 and an obesity-related condition, such as heart disease, diabetes, high blood pressure or severe sleep apnea. Weigh less than 450 pounds, the maximum weight that hospital radiology equipment can accommodate.

How much is Ozempic without insurance?

Ozempic costs $950 to $1,029 without insurance, depending on the pharmacy you use. The price is usually the same for all of the different strength pens.

How to get insurance to pay for GLP 1?

Request Prior Authorization: Your provider will need to submit a prior authorization request to your insurance company. This request should include supporting documentation, such as your medical history, lab results, and a clear explanation of why the GLP-1 medication is necessary for your treatment.

How long do you have to walk each day to lose 50 pounds?

Carlo, a home assistant expert and social media influencer, lost a whopping 50 pounds in 8 months with the help of daily walks. In a viral video he explains exactly how he did it. “I lost around 50 pounds basically walking an hour every day.

Is Ozempic safe for weight loss?

Ozempic is not approved for weight loss, but other related medications like Wegovy and Zepbound are,” he says. “There's a lot to unpack with who should use them, under what circumstances, and the support they need while using it.”

How much water should I drink to lose weight?

For people who are overweight

They should drink more water to remain hydrated and help lose weight. Generally, you should take half of your body weight in ounces of water. Therefore, a person weighing 180 pounds should target about 90 ounces in a day.