Open enrollment for 2024 healthcare plans starts November 1, 2023, and ends January 15, 2024, in most states. Be sure to check your deadlines as some are shorter or longer. Open enrollment is a period that occurs annually and it’s the time to review your insurance coverage and assess whether it aligns with your current healthcare needs. During this period, individuals have the opportunity to enroll in, re-enroll in, or change their insurance policies; those changes would go into effect in January 2024.

If you are considering insurance policy options, you’ll want to ensure they include coverage for any obesity treatments you may be considering or using for the management of this chronic disease.

When evaluating an insurance policy for obesity treatment coverage, there are several key questions you should ask:

  • Does this insurance policy cover obesity treatment(s)?
  • What specific obesity treatment services are covered, such as medical consultations, medications, surgeries, or counseling?
  • Are there any restrictions or limitations on the coverage for obesity treatment?
  • Are there any pre-authorization requirements for obesity treatment services?
  • Are there any exclusions or waiting periods for obesity treatment coverage?
  • Are there specific criteria or guidelines that must be met for coverage, such as a certain body mass index (BMI) or documented medical conditions related to obesity?
  • Are there any lifetime or annual maximum limits on obesity treatment coverage?
  • Are there any co-pays, deductibles, or co-insurance amounts that the patient will be responsible for paying for obesity treatment services?
  • Are there any additional resources or support programs available for obesity management or weight loss, such as nutritional counseling or exercise programs?
  • What documentation or medical records might be required to support the need for obesity treatment services like medications or metabolic-bariatric surgery?
  • How often are follow-up visits or ongoing care for obesity treatment covered?
  • Will obesity treatment coverage extend to prescription medications commonly used for weight management?

Patients should thoroughly review their insurance policy and pose these questions to their insurance provider or employer’s benefits representative in order to understand the terms and coverage limitations related to obesity treatment.

OAC Access to Care resources you’ll want to check out

The OAC continues to fight for access to obesity care and treatments for all who seek them. Help us in this fight by making a donation today