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Insurers Will Address Obesity Under Obamacare

Update Date: Jul 05, 2013 09:37 AM EDT

Obesity was considered a behavioral and personal problem for years until the American Medical Association (AMA) declared obesity a disease. Since obesity contributes to so many health complications, such as diabetes and heart attacks, it is about time that doctors and patients tackle this problem more effectively by treating it as a disease. This label will now require medical professionals to provide more information about the health risks of being overweight or obese as well as developing personalized treatments for losing weight. On top of this extra care and effort that doctors will have to put in, Obamacare will also require many insurance companies to cover obesity care.

Before obesity was named a disease, some insurers were already covering obesity care. These companies agreed to cover weight loss and wellness programs hosted by businesses, schools and within communities. Others paid for obesity prescription drugs and surgeries, such as gastric bypass.

Now, under the latest health care law, the Affordable Care Act, the majority of insurers will have to cover the costs of treating obesity patients, which can range from screening and counseling to dieting programs depending on each individual plan. For example, some companies offer health coaches while others might refer patients to gyms, such as Weight Watchers. According to the law, insurance plans must cover obesity costs if the primary care physician diagnoses a patient as obese based on the patient's body mass index (BMI).

According to spokeswoman, Susan Pisano with the America's Health Insurance Plans, a national trade association that helps represent the insurance industry, parts of the new law requires coverage without patient cost-sharing. This means that many patients will not have to pay co-payments, co-insurance or deductibles. Several plans have already started and more will start by January of next year. Medicare has already started this new service. 

Before this law went into effect and before obesity got the disease label, doctors and patients did not discuss obesity and weight loss goals in much detail. Studies have found evidence that talking about obesity, even it if it occurs with a medical expert can be a very sensitive issue. Under Obamacare, the idea is to promote weight loss by getting doctors to be motivators and educators at no extra cost or at a smaller cost to the patients. 

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