Does TRICARE cover weight loss programs?
Quick Answer
TRICARE covers bariatric surgery when medically necessary with BMI 40+ or BMI 35+ with comorbidities. Nutrition counseling and obesity screening are covered. Commercial weight loss programs and most weight loss medications are not covered.
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Key Takeaways
- Bariatric surgery is covered with BMI 40+ or BMI 35+ with comorbidities
- Nutrition counseling and obesity screening are covered services
- Commercial weight loss programs and supplements are not covered
- Pre-authorization and psychological evaluation required for surgery
Detailed Answer
TRICARE provides coverage for medically necessary weight management services, but does not cover commercial diet programs or most weight loss supplements.
Covered Weight Loss Services
- Obesity screening and counseling at no cost (preventive)
- Nutrition counseling with a registered dietitian
- Medical evaluation and treatment of obesity-related conditions
- Behavioral counseling for weight management
- Supervised medical weight management programs
Bariatric Surgery Coverage
- TRICARE covers bariatric surgery when strict criteria are met
- BMI of 40 or greater (morbid obesity)
- BMI of 35 or greater with at least one obesity-related comorbidity (diabetes, hypertension, sleep apnea)
- Must demonstrate failed attempts at non-surgical weight loss
- Psychological evaluation required before surgery
- Pre-authorization and prior approval required
- Covered procedures include gastric bypass, sleeve gastrectomy, and adjustable gastric banding
Requirements for Bariatric Surgery Approval
- Documentation of at least 6 months of supervised weight loss attempts
- Medical clearance from multiple specialists
- Commitment to lifelong follow-up care
- No active substance abuse or uncontrolled psychiatric conditions
- Must be performed at a TRICARE-authorized bariatric center of excellence
What Is NOT Covered
- Commercial weight loss programs (Weight Watchers, Jenny Craig, etc.)
- Over-the-counter diet supplements and weight loss pills
- Cosmetic body contouring (liposuction, tummy tuck) unless medically necessary after bariatric surgery
- Most GLP-1 weight loss medications for weight management alone (coverage may vary)
- Gym memberships or fitness programs
Nutrition Counseling
- Covered when referred by your provider
- Registered dietitians in the TRICARE network
- Available at many Military Treatment Facilities
- Individual and group sessions available
- Typically covered for obesity, diabetes, and other diet-related conditions
Costs
- Preventive obesity screening: $0
- Nutrition counseling: Standard copay/cost-share
- Bariatric surgery: Standard inpatient copays apply
- Follow-up care after surgery: Standard outpatient copays
Helpful Tips
- Start with your PCM to discuss medically supervised weight loss options
- Document all weight loss attempts if considering bariatric surgery
- Ask about nutrition counseling at your MTF, which is often available at no cost
Related TRICARE Terms
Related Questions
What services does TRICARE cover?
TRICARE covers preventive care, doctor visits, hospitalization, surgery, mental health, maternity, prescriptions, and more with some requiring authorization.
What preventive care does TRICARE cover?
TRICARE covers annual physicals, immunizations, cancer screenings, well-child visits, and other preventive services at no cost with network providers.
What services require prior authorization?
Prior authorization is needed for many inpatient stays, some surgeries, specialty services, DME, and certain high-cost procedures regardless of plan.
What do most military families add to their TRICARE coverage?
Supplemental health insurance is the most common addition — it covers dental, vision, and out-of-pocket costs that TRICARE leaves uncovered. Life insurance and a legal will are also highly recommended.
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