Information About Coverage and Access
Understand your insurance policy
Everyone deserves medical treatment that can improve health and well-being. Understanding how your insurance works and who to contact with coverage questions and concerns is important.
Keep the following tips in mind:
Understand your insurance policy.
If you are denied coverage for weight-management care such as prescription medications or bariatric surgery, talk with your health care provider about additional options to obtain coverage. Review the details of your plan and don’t be afraid to ask your employer. Also, talk to your employer about how you and your health care team can improve coverage for what is needed.
Coverage can vary significantly depending upon where you live. Make sure to read about how your insurance works so that you understand what kind of insurance you have, including your prescription plan.
Obesity Action Coalition (OAC) is also a great resource for more information on navigating insurance policies and access challenges.
Your health care provider and their insurance, billing, and preauthorization departments are great resources for advice and information.
They can help you understand the coverage you have and advocate for you by providing correspondence you can use when speaking with someone in your insurance companies and HR benefits department. Often, a letter addressed to your HR benefits department from your health care provider describing what your coverage needs are can make a difference.
Use the Coverage Request Letter template to help you and your health care provider form a personalized letter that you can give to your HR contact.
The Affordable Care Act requires insurance companies to cover obesity screening and counseling at no cost to you.
If your initial screening shows a BMI that is over 30, you may qualify for additional services as well.
Remember that coverage can vary significantly depending on where you live.
Make sure to read about how your insurance works so that you understand what kind of insurance you have, including your prescription plan.
Managing other health conditions.
Talk to a health care provider about how to stay on top of other conditions you may have. Your weight may have an impact on some health conditions.
Help support the Treat and Reduce Obesity Act
There’s a growing movement to get better insurance coverage for weight management. You can help the cause by learning about and supporting the Treat and Reduce Obesity Act (TROA) to provide more funding and better treatment options for health care providers to address excess weight, including medical intervention, counseling, and prescription medicine.
