Medicare Weight Loss Coverage: Medications, Programs, and Eligibility in 2025

Medicare covers certain weight loss services, programs, and in some cases medications. This guide explains eligibility, what treatments are included, and the outlook for coverage in 2025.

Medicare Weight Loss Coverage: Medications, Programs, and Eligibility in 2025

Obesity and related health conditions are a growing concern among older adults. According to the Centers for Medicare & Medicaid Services (CMS), Medicare already covers some weight loss counseling and bariatric surgery under strict conditions.

What Weight Loss Programs Are Covered by Medicare?

Medicare Part B covers obesity behavioral counseling for beneficiaries with a body mass index (BMI) of 30 or higher. This includes up to 22 sessions per year, provided by a qualified primary care provider.

Some Medicare Advantage (Part C) plans may offer additional benefits, such as weight loss programs, gym memberships, or access to nutrition services. Availability depends on the plan and provider.

Are Weight Loss Medications Covered by Medicare?

Currently, Medicare does not broadly cover prescription weight loss drugs. Medications like phentermine, Contrave, and Saxenda are typically excluded under Part D drug plans. Coverage varies by insurer, and out-of-pocket costs remain common.

Does Medicare Cover GLP-1 Drugs for Weight Loss?

GLP-1 drugs such as Wegovy, Ozempic, and Mounjaro have been approved for weight management in certain patients. As of 2025, Medicare does not yet provide standard coverage for weight loss use of GLP-1 medications. However, Medicare does cover GLP-1 drugs for diabetes management, which may indirectly benefit weight loss.

Will Medicare Cover Wegovy for Weight Loss in 2025?

Policy discussions continue, and there is increasing pressure on Medicare to expand coverage of Wegovy and similar GLP-1 drugs for obesity treatment. As of now, coverage is limited, but future expansions remain possible as research shows positive health outcomes from weight reduction. Beneficiaries should monitor CMS updates and Part D formularies for changes.

Medicare Weight Loss Eligibility

Eligibility for weight loss coverage under Medicare depends on:

  • A BMI of 30 or greater for behavioral counseling.
  • Medical necessity for bariatric surgery.
  • Plan-specific benefits if enrolled in a Medicare Advantage plan.

Medicare Weight Loss Options in 2025

Covered options include:

  • Intensive behavioral therapy and counseling sessions.
  • Bariatric surgery (such as gastric bypass or sleeve gastrectomy) if criteria are met.
  • Nutrition counseling in certain contexts.
  • Possible expanded benefits under select Medicare Advantage plans.

Weight Loss Clinics Accepting Medicare

Medicare covers counseling only when provided by qualified primary care providers. However, some weight loss clinics accept Medicare if they operate within a medical practice or have partnerships with providers. Always confirm clinic participation before scheduling services.

Conclusion

Medicare weight loss coverage in 2025 includes counseling, some surgical procedures, and limited support through Medicare Advantage plans. Coverage for weight loss drugs such as Wegovy remains restricted, though policy changes may expand access in the future. Beneficiaries should review their plan details and consult providers to understand available weight loss benefits.

References (verified)

  1. Medicare.gov – https://www.medicare.gov/coverage/obesity-behavioral-therapy Medicare
  2. CMS NCD 210.12 - https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?NCDId=353 Centers for Medicare & Medicaid Services
  3. CMS NCD - https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?NCDId=57 Centers for Medicare & Medicaid Services
  4. FDA – Wegovy approved to reduce risk of CV death, heart attack, and stroke in adults with CVD and obesity/overweight (opens Part D pathway). https://www.fda.gov/news-events/press-announcements/fda-approves-first-treatment-reduce-risk-serious-heart-problems-specifically-adults-obesity-or U.S. Food and Drug Administration
  5. KFF – Analysis of how Wegovy’s new indication opens the door to Medicare coverage and remaining limits. https://www.kff.org/medicare/a-new-use-for-wegovy-opens-the-door-to-medicare-coverage-for-millions-of-people-with-obesity/ KFF
  6. HHS ASPE issue brief- https://aspe.hhs.gov/sites/default/files/documents/127bd5b3347b34be31ac5c6b5ed30e6a/medicare-coverage-anti-obesity-meds.pdf ASPE
  7. CMS rule- https://www.cms.gov/files/document/submissionofsupplementalbenefitsdataonmaencounterdatarecordsg.pdf Centers for Medicare & Medicaid Services
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