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Is Medical Weight Loss Covered By Insurance?

Medical Weight Loss
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Navigating the maze that is health insurance coverage can be a daunting task, especially when it comes to deciphering what is and isn’t covered. One particular area that often creates confusion is the coverage of medical weight loss treatments.

The road to achieving a healthy body weight can be a difficult journey for many, and medical interventions can offer much-needed support. But does insurance cover these treatments?

What Is a Medical Weight Loss Program and How Does it Work?

A medical weight loss program is an evidence-based approach designed to help individuals achieve sustainable weight loss through the use of weight loss medication. Unlike some other diets and weight loss programs, medical weight loss programs are supervised by medical professionals.

These programs involve regular doctor’s appointments, the prescription of weight loss medication, and ongoing support and monitoring. They are often effective for those who have not been able to achieve their weight loss goals through traditional diet and exercise strategies.

Weight Loss Treatments

What Kind of Weight Loss Treatments Are Covered By Insurance?

Insurance coverage for weight loss treatments varies greatly depending on your specific plan and provider. However, there are a few common types that may be covered:

  1. Bariatric Surgery: This type of surgery includes procedures like gastric bypass and gastric sleeve surgery. Such weight loss surgeries are often covered by insurance if the patient has a Body Mass Index (BMI) above 40 or above 35 with additional health issues like diabetes or hypertension.
  2. Some Prescription Medications: Certain FDA-approved weight loss medications may be covered if deemed medically necessary. Different insurance providers cover different drugs.
  3. Nutrition Counseling: Many insurance plans cover nutrition counseling for weight loss, especially if the patient’s weight is causing or exacerbating health conditions.

What Kind of Weight Loss Treatments Are Not Covered By Insurance?

  1. Cosmetic or Elective Procedures: In most cases, insurance companies do not cover weight loss treatments that they categorize as cosmetic or elective in nature. This typically includes procedures such as liposuction, which is seen as a means of improving one’s appearance rather than a necessary medical procedure.
  2. Over-the-Counter Medications: Non-prescription weight loss supplements and over-the-counter diet pills are not covered as they’re often not recognized as medically necessary.
  3. Some Prescription Medications: Many insurance providers don’t cover certain weight loss medications, even if they’re prescribed. However, drug manufacturers sometimes offer discounts to customers who don’t have coverage.
  4. Weight Loss Programs: Insurance providers typically don’t cover weight loss programs, regardless of whether they’re overseen by medical professionals. However, the medication you’re prescribed as part of such a program could be covered, as could your doctor’s appointments. In addition, your provider could reimburse you or give you a discount for participating in such a program.
  5. Devices: Certain insurance plans cover medical weight loss devices, but many don’t, and some may require you to prove that other weight loss methods haven’t worked to qualify for coverage.

How Much Does Medical Weight Loss Cost without Insurance?

The cost of medical weight loss programs can vary widely, depending largely on the specific treatment plan used and the patient’s condition. The cost of regular doctor’s consultations and prescription medication must be taken into account. For example, Wegovy alone can cost about $1,350 per month without insurance. It’s important to consult your healthcare provider to understand the full range of costs associated with any medical weight loss treatment.

At The Sanctuary, we are committed to providing accessible weight loss medication at low monthly costs. Your initial doctor’s consultation is free, and follow-up consultations are only $99.

Why Choose the Sanctuary?

The Sanctuary Wellness Institute’s medical weight loss program offers a comprehensive, personalized approach to weight loss. Our team of specialized healthcare professionals is dedicated to understanding your unique needs and leveraging effective medication to help you achieve sustainable weight loss. Our program includes regular monitoring to ensure you stay on track with your medication and continue progressing your weight loss goals.

We’re not just about helping you lose weight–we’re about helping you achieve a healthier, happier life.

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