Advanced Medical Weight Loss Augusta offers personalized Medical Weight Loss Programs tailored to each individual, supervised by the physician at every monthly visit on a pay-as-you-go basis. We do not charge for your initial consultation with our program administrator, there are no enrollment fees and no long term contracts. We understand the financial stress of healthcare and we make every effort to keep our costs as low as possible.
The IRS allows people diagnosed by a physician as being obese to deduct the costs of the services in this program. The revenue ruling, IR 2002-19, approves the fees related to services (i.e. medical services and nutrition education meetings). The ruling does not cover the cost for food, which people would have to pay for regardless of their weight. Ask a tax accountant if you are eligible.
- Fees to join a program
- Fees for periodic meetings
- Lab fees
- Examinations by health care professionals
- Weight loss programs undertaken to improve one’s general health or appearance
- Weight loss or diet foods
- Health clubs and spa dues or fees
Insurance carriers are inconsistent and vary greatly in their policies regarding claim payment for weight management programs, and in general, most insurance companies do not reimburse for weight loss services, supplies and maintenance fees. Because of the complexity and expense related to insurance reimbursement, we do not accept any insurance reimbursement at our clinic. We are very happy to give you information for you to give to your insurance company, or to answer any questions they may have.
The Affordable Care Act requires insurance companies to cover obesity screening and counseling at no cost to you. But with other common weight loss treatments, coverage varies depending upon where you live and what health plan you have.
Here are two weight loss services and your insurance plan may cover.
1. Weight loss screening and counseling
Most health plans, including all policies sold through your state’s health insurance marketplace, are now required to offer free screening for obesity as part of guaranteed access to free preventive care. If the screening shows your body mass index (BMI) to be over 30, you qualify for free weight loss counseling as well. However, the law isn’t terribly specific in defining what these interventions must include. As a result, services vary widely.
Even though plans sold through state marketplaces have to cover a set of essential health benefits that include treatment for obesity, they have the flexibility to decide exactly what’s included. According to the Obesity Society, only five states specifically require plans sold through their marketplaces to cover weight loss programs. That often requires you to challenge your health plan to get the services you’re legally entitled to. Check the details of your plan and be prepared to appeal your insurer’s decision if your care is denied.
2. Weight loss medication
Health plans have a spotty history paying for FDA-approved weight-loss drugs, and the Affordable Care Act doesn’t require their coverage specifically. Generally, you’ll need to have a BMI of 30 or a BMI of 27 with obesity-related illnesses for weight-loss medication to be covered.
Please note that if you have a Flexible Health Spending Account (FSA) with your employer, and a BMI of 30 or higher, ALL of our services ARE reimbursable through a FSA program. The key to FSA claims is proper documentation from a physician stating the diagnosis of obesity and its treatment program. We provide this. For further information, call us or contact a tax advisor.