Obesity is a major public health challenge in the United States, with more than 40% of Americans affected. This chronic condition can lead to serious health issues like heart disease, diabetes, and certain cancers.
Fortunately, Medicaid, a government-funded program that provides health insurance to low-income individuals and families, offers various services aimed at combating obesity.
Medications for weight loss
Medicaid’s coverage of weight-loss medications varies by state.
While the federal government provides guidelines, individual states have the flexibility to determine which medications they will cover.
Some popular medications, such as Ozempic (semaglutide) and Wegovy (semaglutide), are FDA-approved for weight loss but can cost over $1,000 per month.
However, some state Medicaid programs may cover these medications for eligible individuals who meet specific criteria.
It’s important to note that weight-loss medications are typically only covered if they are FDA-approved for chronic weight management.
States may also offer coverage for diabetes medications that lead to weight loss as a side effect.
However, if you don’t have Type 2 diabetes, getting coverage for medications like Ozempic can be challenging.
Bariatric surgery Medicaid coverage
Bariatric surgery, which includes procedures like gastric bypass and adjustable gastric banding, is the most commonly covered weight-loss treatment under Medicaid.
As of 2022, 48 states offer some level of coverage for bariatric surgery.
This coverage often includes preoperative evaluations, the surgery itself, hospital stays, and postoperative care.
However, you must meet certain medical guidelines to qualify for coverage, and your state may only cover specific types of surgery.
Because eligibility and coverage rules differ by state, it’s essential to contact your local Medicaid program to learn more about what weight-loss surgeries are covered and the criteria for approval.
Medicaid also covers preventive services like Body Mass Index (BMI) screenings, counseling on healthy eating, and physical activity.
These services are designed to help individuals manage their weight and prevent obesity-related health problems.
For children, these services are available through the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) program.
As obesity continues to be a major health concern, expanding Medicaid’s coverage of weight-loss treatments could play a significant role in improving public health outcomes.