Does Medicare Cover Weight Loss Therapy?

Medicare generally does not pay for weight loss programs for beneficiaries. Under most circumstances, Medicare considers weight loss programs to be elective lifestyle programs that are not covered by Original Medicare (Medicare Part A and Part B). Medicare does, however, cover services such as obesity counseling and nutrition therapy with a dietitian.

Medicare Advantage (Medicare Part C) plans are offered by private companies and cover everything that Original Medicare covers. Most Medicare Advantage plans also offer additional benefits, which often include free gym memberships and other benefits that can help you lead a healthier lifestyle. You can compare Medicare Advantage plans online for free to find out which plans near you cover weight loss programs.

When Are Medicare Weight Loss Programs Covered?

Your Medicare plan pays for medically necessary services that are ordered by your doctor. Services delivered in a hospital setting are generally covered by Medicare Part A, while outpatient services you get in a doctor’s office typically fall under Part B.

Prescription medications are covered by Medicare Part D prescription drug plans. If you have Medicare Advantage, your Part C benefits combine inpatient and outpatient services under a single policy, and most Medicare Advantage plans include prescription drug coverage.

Under some circumstances, Medicare can help pay for weight loss counseling, medication and some other services. If you need to lose weight for an upcoming surgery, for instance, Medicare might be able to assist with some of the cost of weight loss services.

Does Medicare Pay for NutriSystem?

Medicare does not typically pay for NutriSystem or similar weight loss services. The largest component of most privately offered weight loss programs is the food products included in the system, which Medicare generally can’t pay for. This is true even if a doctor prescribes weight loss counseling for you.

Can Medicare Pay for Weight Loss Surgery?

Original Medicare can sometimes help pay for the cost of bariatric, or weight loss, surgery. This can include lap band or stomach reduction procedures, or any other similar treatment that results in significant weight loss. Medicare typically only covers weight loss surgery if you have a high body mass index that’s consistent with medically defined obesity.

Additionally, you typically have to have a history of unsuccessful obesity treatment and a diagnosed illness that the doctor feels is related to your weight. This can include diabetes, sleep apnea or another condition associated with excess weight.