Obamacare: obese adults get special services

Obamacare/Affordable Care Act has a provision to allow obese individuals extra paid visits to providers to help them lose weight.  What providers other than General Practice doctors will be allowed to give these services?

Getting Slimmer

Dear Getting Slimmer,

The service you describe is for adults age 18 or older whose BMI or waist circumference puts them into the obese category.  The parts of the service include loss goal setting, improving diet and nutrition, and strategies to make lifestyle changes.  For all of the details, see the United States Preventive Services Task Force’s recommendation.

Your question raises a very good point — what type of provider is qualified to offer these services.  It comes down to procedure codes.  The insurance company has contracts with various professional people, listing exactly what procedure codes the insurer will pay.  These codes for weight management services might be allowed for psychotherapists, registered dietitians, sports medicine doctors or even physical therapists.

Once you have a documented diagnosis (i.e. the BMI), then you can ask your doctor for referrals to nutrition counselors and the like.  You might want to contact the plan also to find out how to have these services covered as preventive care.  As a preventive service, you should not be charged a co-pay.

And good for you for pursuing better health!

Linda Riddell

About Linda Riddell

A published author and health policy analyst with 25 years’ experience, Linda Riddell's goal is to alleviate the widespread ailment of not knowing what your health plan can do for you.