| HMO | Weight Loss |
| Aetna US Healthcare | Covers: Weight reduction programs provided by HMO.
Excludes: Dietary supplements, surgical operations or procedures for treatment of obesity such as gastric stapling or balloon procedures. |
| Blue Cross Blue Shield | Covers: Surgical treatment of obesity that is life threatening.
Excludes: Any other treatment or regimen, medical or surgical, for the purpose of reducing or controlling weight. |
| CIGNA / Healthsource | Excludes: Any care that is primarily for weight loss, or for any surgical treatment of obesity.
Also excludes drugs and therapies (treatments) used for the purpose of weight loss, dietary supplements, liposuction, abdominoplobly gastic bypass and wiring of jaws. |
| Doctors Health Plan | Covers: Appetite suppressants for a pathological condition such as Narcolepsy or Attention Deficit Disorder. Other services may be covered if medically necessary.
Excludes: Appetite suppressants for other conditions, liposuction or any surgical procedure designed to remove excess fatty tissue unless medically necessary. |
| Generations | Covers: Weight loss only in the case of aggravating medical conditions as determined by physician and with prior approval of Generations.
Excludes: Weight loss services in the absence of aggravating medical conditions. |
| Optimum Choice | Covers: Services and treatments that are within standard medical practice policies and are medically necessary.
Excludes: Services or supplies for weight reduction or morbid obesity treatment, including surgical procedures such as gastric stapling. |
| PARTNERS | Covers: Nutritional counseling for morbid obesity when ordered by a PCP and approved in advance by Partners.
Limits: Limited to 3 visits per 12 consecutive months. Excludes: All other weight loss services. |
| Coventry/Principal Health Care of the Carolinas | Excludes: Weight reduction services such as therapy, surgery, hospitalization, or diet programs. Excludes tests, exams or services for diet programs, such as Optifast, Nutri-system and other similar diet programs. Also excludes surgical procedures for the treatment of obesity, such as intestinal bypass surgery, stomach stapling, balloon dilation, wiring of the jaw and procedures of similar nature. Excludes care for complications from these surgical procedures. |
| QualChoice | Excludes: Any surgery, medical services or supplies meant to control obesity. Excludes dietary control, counseling or weight maintenance programs. |
| The Wellness Plan of North Carolina, Inc. | Excludes: All surgical procedures, services, and supplies for the purpose of weight control, weight management, and commercial weight loss reduction or gain programs. |
| United HealthCare | Excludes: Food supplements, vitamins, any diet or exercise program or any other form of weight control by surgery, including complications of surgery or any other method. |
| WellPath | Excludes: Services intended primarily for weight reduction, such as diet programs, gastric bypasses and balloons, stomach stapling and jaw wiring. Also excludes nutritional counseling and diet planning unless approved in advance by WellPath. |