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If you’re living with obesity and enrolled in Medicare, you might have access to more services than you expect. If you’ve been asking, “Does Medicare cover nutrition counseling for obesity?” you’re in the right place.
Understanding your Medicare coverage can empower you to get the support you need for obesity and related health conditions. Here’s what you should know to make the most of your benefits.
Medicare is a U.S. government-funded health insurance program for people aged 65 and older. Some people under 65 also qualify if they have certain disabilities or health conditions.
Medicare is divided into different parts. Part A covers hospital stays and some skilled nursing care. Part B covers outpatient care, including doctor visits and services like behavioral therapy for obesity. You must sign up for Part B and pay a monthly premium to receive these benefits.
If you have Medicare, it covers many, but not all, of your medical costs. Figuring out what’s covered can sometimes be confusing, especially when you and your doctor are considering the treatments that might work best for you.
Medicare doesn’t specifically cover visits with a nutritionist or nutrition counselor for obesity. However, it does cover a service called intensive behavioral therapy (IBT) for obesity, also known as obesity behavioral therapy.
To qualify, you must have a body mass index (BMI) of 30 or higher. BMI is calculated using your height and weight, which are typically measured during routine obesity screening or when your doctor evaluates your class of obesity.
Even if you meet the qualifications, you’ll need to find a primary care provider who offers this type of therapy. Medicare requires that obesity behavioral therapy be provided by a primary care doctor, nurse practitioner, or other practitioner in a primary care setting, such as a doctor’s office.
Some primary care providers may not have the time, training, or interest to offer this type of counseling. Others may not accept Medicare.
If your doctor does provide intensive behavioral therapy and accepts Medicare, you shouldn’t have to pay anything out of pocket for this service.
IBT for obesity includes several steps designed to support sustainable, healthy weight loss. Your doctor will monitor your weight and BMI, assess your eating habits, and work with you to set and reach goals for your diet and physical activity.
Your primary care provider should use the set framework for IBT, whether the sessions are one-on-one or in a group. This approach includes:
IBT can look different for everyone. It’s designed to meet your unique health needs and goals. For example, some people may explore emotional eating. Others might focus on exercising safely with a chronic condition or injury. Still others may want help planning meals or discovering healthy recipes they enjoy.
Under Medicare, you can get up to 22 IBT visits in a year:
This schedule gives you the time and support to better understand your habits and make meaningful changes. The goal is to help you move toward a healthier weight and maintain that progress beyond your first year.
If you’re enrolled in Medicare, have a BMI of 30 or higher, and your doctor provides IBT, Medicare should cover the cost. The Centers for Medicare & Medicaid Services (CMS) does not require preapproval or a formal application for this benefit.
If you’re unsure whether you qualify for IBT, talk to your doctor or someone in their office. They can help confirm your eligibility and check that the therapy will be covered. You can also call Medicare directly at 1-800-MEDICARE (1-800-633-4227) to ask questions and make sure everything is in place before starting therapy. TTY users can call 1-877-486-2048.
Sometimes, obesity occurs alongside comorbidities (other health conditions), such as type 2 diabetes or kidney disease. When this happens, Medicare may cover additional nutrition services.
If you’ve been diagnosed with diabetes or kidney disease or had a kidney transplant in the past three years, you may qualify for medical nutrition therapy (MNT) services through Medicare Part B. However, Medicare does not cover MNT if obesity is your only diagnosis.
Covered MNT services may include:
To use these services, you’ll need to see a qualified nutrition specialist, such as a registered dietitian, who meets Medicare’s provider requirements. In most cases, you’ll also need a referral from your doctor.
Your dietitian may meet with you several times. If they believe you need more time or sessions, they’ll work with Medicare to request additional hours. If you’re unsure what your plan covers, contact the provider’s office before your appointment. They can help answer questions and check your coverage.
In some cases, Medicare may offer additional support for people living with obesity. If you have a Medicare Advantage Plan (also known as Medicare Part C), you can contact your plan directly to ask what services they cover. These plans are offered by private companies approved by Medicare, and coverage can vary.
Medicare may cover bariatric surgery — such as gastric bypass or sleeve gastrectomy — for people with a BMI of 35 or higher. To qualify, you typically need to:
If you meet these requirements, Medicare may help cover the costs of surgery.
If you’re living with obesity and have Medicare, talk to your doctor about the treatment options available to you, including nutrition counseling or behavioral therapy. Your healthcare provider can help you understand what’s covered, refer you to the right specialists, and guide you toward a treatment plan that supports your health and well-being.
MyObesityTeam is the social network for people with obesity and their loved ones. On MyObesityTeam, more than 57,000 members come together to ask questions, give advice, and share their stories with others who understand life with obesity.
Have you had nutrition counseling covered by Medicare? How did it help you in your life with obesity? Share your experience in the comments below, or start a conversation by posting on your Activities page.
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