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Medicare covers behavioral counseling sessions to help you lose weight. This counseling may be covered if you get it in a primary care setting (like a doctor’s office), where it can be coordinated with your other care and a personalized prevention plan. Talk to your primary care doctor or practitioner to find out more.
Who’s eligible?
All people with Medicare Part B (Medical Insurance) who have a body mass index (BMI) of 30 or more are covered.
Your costs in Original Medicare
You pay nothing for this service if the primary care doctor or other qualified primary care practitioner accepts assignment.
Note
Your doctor or other health care provider may recommend you get services more often than Medicare covers. Or, they may recommend services that Medicare doesn’t cover. If this happens, you may have to pay some or all of the costs. It’s important to ask questions so you understand why your doctor is recommending certain services and whether Medicare will pay for them.
Bariatric surgery
Who’s eligible?
Medicare covers some bariatric surgical procedures, like gastric bypass surgery and laparoscopic banding surgery, when you meet certain conditions related to morbid obesity.
Note
Your doctor or other health care provider may recommend you get services more often than Medicare covers. Or, they may recommend services that Medicare doesn’t cover. If this happens, you may have to pay some or all of the costs. It’s important to ask questions so you understand why your doctor is recommending certain services and whether Medicare will pay for them.
Your costs in Original Medicare
For surgeries or procedures, it’s difficult to know the exact costs in advance because no one knows exactly what services you’ll need. If you’re having surgery or a procedure, you can do some things in advance to figure out approximately how much you’ll have to pay.
- Ask the doctor, hospital, or facility how much you’ll have to pay for the surgery and any care afterward.
- Make sure you know if you’re an inpatient or outpatient because what you pay may be different.
- Check with any other insurance you may have (like a Medicare Supplement Insurance (Medigap) policy, Medicaid, or coverage from your or your spouse’s employer) to see what it will pay. If you belong to a Medicare health plan, contact your plan for more information.
- Login to MyMedicare.gov, or look at your last “Medicare Summary Notice” (MSN) to see if you’ve met your deductibles.
- Check your Part A deductible if you expect to be admitted to the hospital.
- Check your Part B deductible for a doctor’s visit and other outpatient care.
- You’ll need to pay the deductible amounts before Medicare will start to pay. After Medicare starts to pay, you may have copayments for the care you get.
