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Medicare Extends Obesity Coverage: New Weight Loss Benefits and Services

By Aurora D. Pryor, MD, Director, Bariatric and Metabolic Weight Loss Center

Dr. Aurora D. Pryor
Dr. Aurora D. Pryor

Medicare is now covering medical weight loss programs! This coverage includes the preoperative medically-supervised program required for weight loss surgery. Our program at Stony Brook is ideally geared for people with obesity, and it should meet all the Medicare requirements.

The Medicare rules cover multidisciplinary weight management appointments for individuals with a body mass index (BMI) of 30 or higher up to once a week for the first month and then twice a month for the next five months. (Calculate your BMI with an online calculator.) Plus, if you lose at least 6.6 pounds during that time, Medicare will cover another 6 months.

The Stony Brook Bariatric and Metabolic Weight Loss Center delivers an integrated and accessible weight loss program with regular monthly sessions. We seek to develop a sustained partnership with our patients to improve their overall health and the health of our community in general. In our program, we assist our patients by identifying personal health risks and behaviors, and collaboratively develop solutions for healthy long-term success.

Medicare, the nation’s medical safety net for seniors, just announced that it is extending its coverage for obesity screening and counselling, ensuring that roughly 30% of its 42 million beneficiaries can undertake a weight loss program supervised by a qualified physician.

"Obesity is a critical public health problem in our country that causes millions of Americans to suffer unnecessary health problems and to die prematurely. Treating obesity-related illnesses and complications adds billions of dollars to the nation's healthcare costs," said Tommy G. Thompson, Secretary, U.S. Department of Health and Human Services.

Commenting on the 2004 Medicare policy change that redefined obesity as an illness, Thompson underscored the benefits of the new policy, saying "Medicare will be able to review scientific evidence in order to determine which interventions improve health outcomes for seniors and disabled Americans who are obese."

Read the official announcement from the Centers for Medicare & Medicaid Services (CMS) about the newly extended Medicare coverage for obesity, and the final CMS decision on the coverage determination.

For more information about the weight loss program at Stony Brook, please visit our center's website (click here to go there) or call HealthConnect at 631-444-4000 to register for one of our free information seminars. Follow Dr. Pryor on Twitter!