Obesity in the senior population is a significant health problem in the United States. In this country, over 28 percent of people over the age of 65 have a body mass index (BMI) that is 30 or more. According to medical professionals, a BMI of 30 and above indicates obesity. Being obese lowers quality of life in general, but it also increases the risk for a list of serious health problems from hypertension and heart disease, to respiratory problems and even cancer.
In order to prevent these health risks, doctors commonly recommend a healthy diet and exercise, but conventional diets do not always work for everyone. Some people struggle with weight loss success on their own and find that the best solution is to use weight loss programs similar to the Nutrisystem program.
Because of the high medical costs associated with unhealthy weight levels, insurance companies and Medicare may cover the cost of some weight loss programs. Obesity is a treatable condition, but losing weight alone is not always easy.
What is Nutrisystem?
Nutrisystem is the name of a company in the United States that provides weight loss, weight management, and nutrition products to people looking for help in losing weight. The aim of the program is to make dieting easier by providing meals that are portion-controlled and have the appropriate amounts of calories and carbohydrates. You do not need to count or weigh anything.
Nutrisystem ships the food to your home. Each package includes three meals and a dessert. You are also allowed additional fruit, vegetables, and snacks that you buy on your own. Weight loss programs such as Nutrisystem sell precooked meals that are delivered to your home. Depending on the plan you choose, costs run between $275.00 and $600.00 a month.
Programs like these are geared for people who need convenience and discipline, but they are not for everyone. You can consult your health care provider to learn more about these types of programs or what services your Medicare benefits cover to help you with your weight loss goals.
Do Medicare Benefits Cover Nutrisystem?
With programs like Nutrisystem, the main cost involved is for prepared food products. Unfortunately, Medicare does not offer coverage to Medicare recipients for these types of services even if a health care provider prescribes such a program to help you lose weight.
Medicare Coverage for Weight Loss InterventionHowever, your Medicare benefits may pay for other forms of weight loss intervention in clinical settings if they have been ordered by your health care provider.
Medicare recipients who have Part B (medical insurance) and have a BMI of 30 or more, have coverage for obesity behavioral therapy. This includes an obesity screening and behavior counseling. Medicare Part B pays for 100 percent of the cost of these services if your primary care doctor, or qualified primary care practitioner accept Medicare assignment.
Obesity screening and behavior counseling services include the following:
• An initial screening to determine your body mass index.
• Behavioral therapy sessions that include a dietary assessment and counseling. The purpose of these therapy sessions is to help you lose weight by focusing on your nutrition and exercise program.
In order to be eligible for Medicare coverage of these counseling sessions, they must take place in a primary care setting like your doctor’s office or a clinic. Medicare Part B covers medical nutrition and weight loss therapy as preventive services for Medicare beneficiaries who have diabetes or have had a kidney transplant within the past 36 months. Your physician must order them as medically necessary to receive coverage.
Medicare Part B also offers coverage for their Diabetes Prevention Program if you meet the following criteria:
• You have a BMI of 25 or higher, or above 23 for people of Asian heritage.
• You have a diagnosis of either Type 1 or Type 2 diabetes.
• You have end-stage renal disease.
• It is your first time participating in the Medicare Diabetes Prevention program.
• Your blood exams are at levels set by Medicare.
This program teaches weight loss and weight management strategies, and Medicare pays 100 percent of the cost when it is provided in an approved primary care setting.
If you have a Medicare Advantage (Part C) plan, it may include coverage for home-delivered meal programs like Nutrisystem. This depends on your individual policy and you should get details from your plan regarding weight loss program coverage.