Medicare pays for some weight loss treatments related to obesity, including counseling and certain surgeries. However, it does not usually cover weight loss programs for general health.
This article explains when Medicare might cover weight loss programs. It also looks at what weight loss services Medicare covers.
Glossary of Medicare terms
We may use a few terms in this article that can be helpful to understand when selecting the best insurance plan:
- Out-of-pocket costs: An out-of-pocket cost is the amount a person must pay for medical care when Medicare does not pay the total cost or offer coverage. These costs can include deductibles, coinsurance, copayments, and premiums.
- Deductible: This is an annual amount a person must spend out of pocket within a certain period before an insurer starts to fund their treatments.
- Coinsurance: This is the percentage of treatment costs that a person must self-fund. For Medicare Part B, this is 20%.
- Copayment: This is a fixed dollar amount a person with insurance pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.
Medicare covers some weight loss services, but coverage often does not include weight loss programs.
This is because Medicare coverage tends to consider weight loss programs “lifestyle enhancement services,” which are services that may support a person’s overall health, but do not directly treat a specific medical issue.
However, some people need to take part in a weight loss program ahead of bariatric surgery or other procedures for which it would be beneficial for a person to lose weight beforehand.
Medicare Part B covers situations in which Medicare will pay for a presurgical weight loss program. In these instances, a doctor must deem a weight loss program medically necessary and a Medicare-approved facility must provide it.
For services with coverage under Part B, Medicare pays 80% of costs after a person meets their $240 annual deductible.
A weight loss program at an inpatient skilled nursing facility would fall under Medicare Part A. This has a deductible of $1,632 in 2024. After a person meets this, Medicare pays for all medically necessary care during the first 60 days of treatment.
While Medicare does not usually pay for weight loss programs, coverage can fund certain elements of obesity support. For example:
- Part A covers in-hospital care such as surgery
- Part B covers outpatient consultations and medical care
- Part D covers prescription medications
Intensive behavioral therapy for obesity
Medicare may cover intensive behavioral therapy for obesity under Part B.
To qualify, the person must have a
The flaws of BMI
BMI is a calculation of a person’s body fat based on their height and weight. However, studies suggest it is a poor indicator of a person’s body fat percentage.
It can be misleading because the measure does not account for overall body composition or capture information on the mass of fat in different body sites. The latter relates to both health and social issues.
BMI cutoff points were generated mostly from the white population, but body fat distribution differs by race and ethnicity.
For additional information, talk with your doctor about other body fat assessment methods.
Intensive behavioral therapy includes :
- an initial screening to calculate BMI
- a dietary assessment
- counseling on diet and exercise
The beneficiary will need to pay for any additional weight loss services for which a doctor refers them, such as a consultation with a registered dietitian or nutritionist.
Bariatric surgery
Bariatric surgery alters the way the digestive system works to support weight loss and improve metabolism.
Medicare Part A pays for bariatric surgery for people who have a BMI of 35 or higher and another related health problem, such as:
A provable history of previously ineffective weight loss treatment is also necessary. A doctors’s letter or counseling notes may support this.
Types of procedures
Bariatric procedures Medicare may cover include:
- adjustable or vertical gastric banding
- biliopancreatic diversion with duodenal switch
- Roux-en-Y gastric bypass
- sleeve gastrectomy
A person’s doctor can advise on what procedure they recommend. A person should check that Medicare covers the treatment before proceeding with the surgery.
Learn more about Medicare coverage for weight loss surgery.
Medicare Advantage wellness services
Medicare Advantage, also called Medicare Part C, may pay for some additional wellness services that can support healthy weight loss. This can include gym memberships.
Some Medicare Advantage plans may also pay for the fitness program SilverSneakers.
In some cases, Medicare Advantage may also offer meal delivery services. According to the Kaiser Family Foundation, around 72% Medicare Advantage plans offer meal benefits, including meal delivery services, in 2024.
Medicare does not pay for programs such as Weight Watchers (WW).
It also does not cover weight loss procedures a person receives for cosmetic reasons, such as liposuction.
Medicare resources
For more resources to help guide you through the complex world of medical insurance, visit our Medicare hub.
What weight loss drug is covered by Medicare?
Medicare Part D covers medications, but it does not fund weight loss medications such as Ozempic and Wegovy when a person takes them exclusively to lose weight.
Does Medicare pay for Wegovy or Ozempic?
Medicare Part D will pay for Wegovy if a person has cardiovascular disease and overweight. Part D covers Ozempic as a treatment for diabetes.
Does Medicare cover weight loss surgery?
Medicare will pay for medically necessary bariatric surgery, including adjustable gastric banding, biliopancreatic diversion with duodenal switch, Roux-en-Y gastric bypass, sleeve gastrectomy, and vertical gastric banding.
Does Medicare cover belly fat removal?
Medicare does not pay for liposuction or any weight loss surgery a person receives for cosmetic reasons.
Original Medicare does not cover weight loss programs, but Medicare Advantage may include wellness or preventive services such as gyms or fitness programs, including SilverSneakers.
Other weight loss services that Medicare pays for include bariatric surgery and obesity behavioral therapy, depending on factors such as BMI and a history of other weight loss treatments.
Medicare only covers weight loss drugs such as Ozempic and Wegovy if a doctor prescribes them for other conditions, namely cardiovascular disease and diabetes.
A person can contact Medicare to find out more about weight loss programs their plan may cover.