Affordable Care Act Will Cover Weight Loss Medical Services

Coverage does not necessarily cover weight loss programs like Weight Watchers.

ByABC News
July 9, 2015, 10:48 AM

— -- Losing weight is a universal struggle but now some weight loss efforts may not cost you as much money out of pocket.

Weight loss programs that involve professional weight loss doctors or nurses and registered dieticians are now covered under the Affordable Care Act, legislation that expanded health coverage to millions of Americans and was upheld for a second time last month by the U.S. Supreme Court.

The ACA, signed into law by President Obama in 2010, requires insurers to pay for nutrition and obesity screening.

Nanette Blumberg, who has struggled with weight for most of her life, was shocked when her doctor’s program of high-protein foods, counseling and exercise was reimbursed by her insurance company.

“It was a great help," Blumberg told ABC News. "I had a $20 deductible and that was nothing in compared to what I would have had to pay if I didn’t have insurance."

Blumberg, of Westchester, New York, has lost more than 30 pounds and dropped her body mass index (BMI) to 27.

Dr. Michael Kaplan, who runs the Long Island Weight Loss Institute, said patients are now paying between 40 and 80 percent less for his services since insurance started covering them.

Curretly, 23 states cover bariatric or gastric bypass surgery, and 16 states now include some coverage for dietary and nutritional screening, counseling and weight loss programs, according to a report published online Friday in the New York Times.

People don’t have to be severely overweight to be covered. Those with a BMI of more than 30, or those with a BMI of 27 with obesity-related disease, such as diabetes, will be covered.

“By helping them to lose weight, often times their diabetes, their hypotension improves, their osteoarthritis, their back pain,” Kaplan said.

Coverage is limited to treatment obtained from professional weight loss doctors or nurses and registered dieticians, but not necessarily to weight loss programs such as Jenny Craig and Weight Watchers. Supplements, pills and shakes are not covered, although some prescriptions are.

While the coverage opens doors for people like Blumberg, there are concerns that it is also creating a financial opportunity for some unproven weight loss methods.

"There will be people that will offer quick fixes, that say, 'Look, I can help you lose weight in six months, three months, 30 days,'" Maya Feller, a New York-based dietitian, told ABC News. "It's just not sustainable."