Does Medicare cover weight-loss programs or bariatric surgery if I’m classified as obese?

Answered by 8 licensed agents

If you have a body-mass index (BMI) greater than or equal to 30, Medicare covers obesity screenings and behavioral counseling to help you lose weight by focusing on diet and exercise.

Medicare covers some bariatric surgical procedures when you meet certain conditions related to morbid obesity.

Conditions that must be met to qualify:

The beneficiary has a body-mass index (BMI) greater than or equal to 35.

The beneficiary has at least one co-morbidity related to obesity such as cardiovascular disease, chronic obstructive pulmonary disease or type 2 diabetes mellitus.

The beneficiary has been previously unsuccessful with medical treatment for obesity.

Answered by Robert Vaughan, R.Ph., MBA on May 6, 2025

Broker Licensed in CA, AZ, NM, NV & TX

Answered by Robert Vaughan, R.Ph., MBA Medicare Insurance Agent
Medicare may cover weight loss counseling and in some cases, bariatric surgery, if it's medically necessary and done at a Medicare approved facility. Coverage depends on your health conditions and meeting certain criteria. I can help you check if you qualify.

Answered by Michelle Simonds on May 5, 2025

Agent Licensed in PA, FL & NY

Answered by Michelle Simonds Medicare Insurance Agent
Medicare can cover weight loss programs and surgery in certain cases. Usually you will need to have a certain BMI (Body Mass Index) and be under the care of a specialist. Once criteria is met, the specialists office will submit paperwork to your plan for approval.

Answered by Susan Kainrath on May 6, 2025

Broker Licensed in IL & IN

Answered by Susan Kainrath Medicare Insurance Agent
Yes, Original Medicare covers weight-loss counseling and specific surgeries for people who have a body mass index of 30 and above and meet other criteria.

Furthermore, Medicare covers some types of bariatric and metabolic surgery for people who meet certain conditions associated with morbid obesity, a body mass index of 35 or above, and other conditions.

Source: www.aarp.org.

Answered by Andrew Zurbuch, MBA on May 5, 2025

Broker Licensed in IN, FL, KY, MO, OH & TN

Answered by Andrew Zurbuch, MBA Medicare Insurance Agent
Medicare may cover certain weight-loss services if you’re classified as obese (BMI of 30 or higher), but coverage is limited. Medicare does not cover commercial weight-loss programs or meal plans. However, it does cover obesity screening and behavioral counseling through your primary care provider, and may cover bariatric surgery (like gastric bypass or sleeve gastrectomy) if you meet specific medical criteria, such as having other health conditions like diabetes or heart disease. Prior authorization and documentation are typically required.

Answered by David Silver on May 6, 2025

Broker Licensed in FL, NJ & NV

Answered by David Silver Medicare Insurance Agent
Yes, Medicare can cover bariatric surgery for those with severe obesity, but it generally does not cover weight-loss programs or medications for obesity alone. Bariatric surgery may be covered if your BMI is 35 or higher and you have a co-morbid condition related to obesity, and if you've previously tried and failed medical treatment for obesity.

Answered by Fred Manas on May 4, 2025

Agent Licensed in NY, CT, DC & 7 other states

Answered by Fred Manas Medicare Insurance Agent
Yes, Medicare may cover certain obesity-related treatments:

* Bariatric surgery is covered if you meet medical criteria (BMI ≥35 with related conditions like diabetes) and the surgery is done at a Medicare-approved facility.

Answered by Sam Silva on May 4, 2025

Broker Licensed in FL, GA, NJ & 7 other states

Answered by Sam Silva Medicare Insurance Agent
If someone is classified as obese, Medicare may approve a weight loss surgery when the BMI is above 35 and if there is another compounding health issue like diabetes or high blood pressure. Medicare does not pay for general weight loss programs or weight-loss medication.

Answered by Alexander Lehn on May 6, 2025

Agent Licensed in NV, CA, FL & TX

Answered by Alexander Lehn Medicare Insurance Agent

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