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Health Reform 101

with Lisa Zamosky

WebMD helps readers understand their health insurance and the new health care reform law. The Affordable Care Act is bringing sweeping changes to American health care. Lisa Zamosky is here to help you navigate the health care maze and understand how these changes affect you.


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Tuesday, December 6, 2011

Obesity Counseling Now Comes Free for Medicare Beneficiaries

By Lisa Zamosky

If you have Medicare and have been wishing you could get help dropping extra weight, here’s some good news.

Last week the Centers for Medicare & Medicaid Services (CMS) announced that among the preventive services available to Medicare beneficiaries with no cost-sharing, obesity counseling and screening has been added to the list.

In a statement, CMS Administrator Donald M. Berwick, MD said, “Obesity is a challenge faced by Americans of all ages, and prevention is crucial for the management and elimination of obesity in our country. It’s important for Medicare patients to enjoy access to appropriate screening and preventive services.”

The move is a recognition that obesity is a growing problem (no pun intended!) in this country and one that needs to be addressed. In fact, according to CMS, more than 30% of the Medicare population is obese, a condition associated with a rise in cardiovascular disease and diabetes, among other chronic diseases.

Gaining Access to Obesity Counseling

The new benefit goes into effect immediately. It works like this: Patients with a body mass index (BMI) of 30 or greater qualify for one face-to-face counseling visit per week for one month, as well as counseling visits every other week for an additional five months.

If you lose 6.6 pounds during the first six months of counseling, you qualify for another round — one counseling session per month for another six months with a possible extension of up to a total of 12 months.

This is the first time doctors will be reimbursed for talking with their patients about diet and exercise and generally working with them to develop a plan for losing excess weight.

Preventive Services for Medicare Beneficiaries

At the beginning of this year, Medicare beneficiaries gained access to a host of preventive services without cost-sharing as a result of the Affordable Care Act. Obesity counseling and screening is just the latest service added.

According to CMS, nearly 23 million people with Original Medicare received at least one free covered preventive service as of the end of October, 2011. Generally, this has been one of the more popular aspects of the health reform law, which requires both Medicare and private insurers to pay for preventive care without any cost (in the form of co-pays or co-insurance) to patients.

Sound off: Have you had your free annual physical exam or taken advantage of preventive cancer or other screenings this year? What services are you most pleased to see on the free preventive services list? Share your thoughts in the comments below.

Posted by: Lisa Zamosky at 2:30 pm


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