Medicare to cover preventive care for obese

Medicare will pay for screenings, counseling, and other preventive services to help reduce obesity rates and associated health risks, such as heart disease, strokes, and diabetes, the Centers for Medicare & Medicaid Services (CMS) announced last week. Coverage begins immediately.

With this decision, Medicare will ensure that roughly 30 percent of its 42 million beneficiaries can participate in a weight-loss program supervised by their doctor, the Los Angeles Times reports. "This decision is an important step in aligning Medicare's portfolio of preventive services with evidence and addressing risk factors for disease," said CMS Chief Medical Officer Patrick Conway.

Patients are eligible for preventive services if they meet the standard definition of obese, meaning their body mass index is 30 or higher. Covered benefits include one face-to-face counseling session every week for a month, then counseling every other week for five months. If patients lose at least 6.6 pounds at the end of six months, Medicare will pay for an additional six monthly counseling sessions, according to Kaiser Health News.

Some advocates hope Medicare's decision will prod private insurers into covering obesity screening and counseling as well, particularly since being overweight for five years costs up to $24,000 per person. The STOP Obesity Alliance estimates that 50 percent of U.S. adults will be obese by 2030, USA Today reports. Currently, many private plans provide coverage for bariatric surgery but not preventive service like counseling, notes KHN.

"Obesity is a challenge faced by Americans of all ages, and prevention is crucial for the management and elimination of obesity in our country," said former CMS Administrator Dr. Donald Berwick.

To learn more:
- read the CMS decision memo
- read the Kaiser Health News article
- see the Los Angeles Times article
- check out the USA Today article

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