If you are overweight or obese, chances are your insurance company will offer some sort of incentives and programs to encourage weight loss. It is expensive, so utilizing the help you can get through your insurance company is vital. If you are obese or morbidly obese according to your doctor, most insurance companies will support you in your weight loss efforts.
Being severely overweight is a direct or indirect cause of many medical conditions; being 75 or 100 pounds overweight puts you into a borderline disabled category, so seek available help. Experts tell us that even modest weight losses can help control diabetes or high blood pressure, so it is worth the effort!
Good news is that insurance companies today often cover the costs of many weight loss treatments. Sometimes, the insurance company will administer the program itself much the same way as Kaiser Permanente utilizes its Balance programs online and at its facilities. You should call your insurance company, or ask your primary care doctor if there are any health incentive programs available. Other insurers outsource to vendor weight loss programs:
Jenny Craig provides a customized program for each person and focuses on diet, exercise, and nutrition. They understand about emotional eating, poor relationships with food, and how to help members make positive changes to their lifestyle. Insurers like GHI Health Insurance and Regence offer large discounts for Jenny Craig’s system, and others will pay the full cost if you have a doctor's prescription.
NutriSystem offers a weight management and nutrition program that delivers prepared foods to your door, making it easier to choose the healthy meals you should. They have different programs designed for diabetic patients and men and women. CIGNA Insurance offers numerous incentives through a program it calls Healthy Rewards. You can get discounted NutriSystem membership as well as discounted fitness club memberships.
The Weight Watchers program of healthy eating and making more nutritious food substitutions has a long track record of success. Typically, members attend a group meeting once a week and then watch their assigned “points” the rest of the time. Once the points are gone, they are finished eating for the day. Unity Health Insurance reimburses its insured members 50% of the costs.
Optifast is a liquid diet program, medically supervised, and includes healthy supplementation. There are counseling sessions and lab tests to support the program and increase its effectiveness. Medicare will cover part of the Optifast program fees, and many other insurance companies do, too. Optifast clinics usually will allow payment plans on the balance that remains.
Though it is not to considered an instant fix, bariatric surgery is an option for those people who are extremely overweight or who have co-morbidities like high blood pressure and diabetes. Insurance companies are much more likely to entertain this option than in years past because of the long-term success rates with bariatric programs. It may not be an immediate answer, but it does seem to be a lasting one for most patients.
Most insurance companies follow a pre-determined program for their bariatric surgery departments.
Candidates referred by their primary care doctors must attend an orientation session, which goes over the options and answers questions.
Candidates who wish to move forward enroll in the program. They also begin right at that point to eat more healthfully and to exercise regularly.
The preauthorization with your insurance company begins around this time as well. Medicare and state medical assistance programs can also help.
You will meet with a nutritionist and talk about what you have been eating and how you need to alter that up to and after surgery.
Work with the program directors to get your surgery preauthorized by your insurance company or Medicare.
Meet with your surgeon to set a surgery date and find out what necessary exams and testing need to be done prior to surgery.
Continue regular exercise and practice eating the way you will after surgery, as one with a smaller stomach. Reducing portion sizes, pacing your intake, chewing very well, and making wise choices is necessary.
- Visits with the nutritionist and counselors during the pre-surgery period will help ensure your success for the long haul.
Gaining authorization from your insurance company for the costs of surgery is not as difficult as it once was; insurers now realize that incurring those costs will result in a healthier patient with less medical conditions overall.
Your primary doctor’s referral letter goes a long way toward outlining the health conditions faced because of obesity. In addition, your own health records and receipts for all health-related expenses need kept. These include information about any weight loss groups or programs, diet centers, and health clubs you have utilized in an attempt to lose weight.
Speak with the insurance company every couple of weeks to check on the progress of your preauthorization. Also, have an appeal letter readied at this stage and have it signed by your primary doctor or your surgeon. If your initial request is denied, send your appeal promptly.
No matter which option or options you choose, you need to be aware that help is available to help you lose weight and get healthy in the form of insurance.
Denise Gabbard writes about diverse topics like travel, health and fitness, and personal finance and insurance, including dr10 insurance.