Starting in December 2011, Medicare will cover body mass index (BMI) screenings and behavioral counseling for all people with Medicare who are obese. Medicare will only cover the screening and counseling sessions if you receive them in your doctor’s office or other primary care setting.
Persons are obese if they have a Body Mass Index (BMI) of 30 or more.
Once your primary care doctor or other health care provider concludes that you are obese, you can qualify for behavioral counseling and therapy. This counseling is intended help you lose weight and sustain your loss through proper diet and exercise.
You are entitled to a series of visits. Medicare will cover:
- One face-to-face visit every week for the first month;
- One face-to-face visit every other week during months 2-6;
- One face-to-face visit every month during months 7-12, if the beneficiary loses 6.6 lbs after the first six months.*
*During your six-month visit, you will be re-screened for obesity. During this re-screening, your doctor will measure how much weight you have lost since your initial screening, if any. To be eligible for additional face-to-face visits with your doctor during months 7-12 of your behavioral therapy, you must lose at least 6.6 lbs (3 kg) during the first six months of therapy. To continue receiving the preventive benefit without charge, your doctor must document all the weight you lose. If you do not lose at least 6.6 lbs during your first six months of behavioral visits with your doctor, your therapy will typically end. Your doctor can reassess you for another obesity screening preventive benefit after another 6 months have gone by.