Weight Management Coverage

All active U.S. employees and their family members and pre-Medicare retirees and their family members enrolled in either the MAP Plus Option 1 Low Deductible or MAP Plus Option 2 High Deductible benefit plans are eligible for weight management coverage. Eligible expenses are covered at 100% before deductible and have no annual limit.

What are eligible expenses for weight management?

Eligible expenses for weight management include:

  • Individual consultation with a registered dietitian
  • Group consultation with a registered dietitian
  • Support Group
  • Class or Workshop Membership (e.g., Weight Watchers, Jenny Craig)

The reimbursement program does NOT cover:

  • Experimental treatments
  • Diet products or food supplements of any kind
  • Self-help materials such as books or computer software
  • Vitamin, mineral or other supplements
  • Alternative therapies such as acupuncture or hypnosis
  • Cooking products
  • Surgical procedures and prescription weight loss drugs
  • Unproven weight management programs or products

How do I take advantage of the Weight Management Coverage benefit?

  1. Participate in an appropriate program/counseling service and get a copy of the bill (bill should include the facility name, facilitator credentials, if appropriate, and indicate that it is a weight management program/consultation). If you are submitting an invoice, e.g. Weight Watchers, submit a copy of your paid invoice or credit card statement.
  2. Attach copies of your receipt(s) with a completed Aetna Medical Claim Form and mail to:

    Aetna
    PO Box 981106
    El Paso, TX 79998-1106

How will I receive my reimbursement?

The weight management reimbursements are processed the same way as any other health care claim. After your claim is processed and approved, you will receive payment directly from Aetna.

What is the deadline to submit my reimbursement request?

Similar to other health care claims, you must submit your reimbursement request by the end of the year following the year of service/purchase. For example, a claim incurred in February, 2018 must be submitted by December 31, 2019.

Are there other coverage options for obesity?

Members may be eligible for prescription medication and/or obesity surgery coverage. It is recommended to contact AETNA at 1-888-488-4488 to fully understand this coverage and talk to your personal health care provider to determine if/how it applies to your personal situation.

If you have questions, please contact Aetna One Advocate toll free
Monday - Friday, 8:00 a.m. - 8:00 p.m. ET at 1-888-488-4488