Milly Gaines
Medicaid is a federal-state program that provides health coverage for eligible individuals, including those with disabilities or special health needs. The benefits offered by Medicaid can vary across states, and while some mandatory services are provided by all states, others offer additional benefits like nutritional counseling and weight management programs. These services are designed to help individuals improve their health through specialized diets and lifestyle changes, with the support of registered dietitians and nutritionists. As of 2020, states like North Carolina have expanded their Medicaid coverage to include nutritional services for pregnant women and people under 21.
| Characteristics | Values |
|---|---|
| Coverage | Basic Plan, Enhanced Plan, Medicare Medicaid Coordinated Plan |
| Basic Plan Coverage | Annual physicals, immunizations, most prescriptions, doctor and hospital visits |
| Enhanced Plan Coverage | All benefits of the basic plan, plus additional specialized benefits |
| Eligibility for Enhanced Plan | Individuals with disabilities or special health needs, referred by a doctor |
| Foodsmart Benefits | Working with a nutrition coach to create a personalized plan, money-saving shopping tips, eligibility for SNAP benefits, meal plans, grocery ordering |
| Medical Conditions Addressed | Heart conditions, diabetes, cancer, digestive disorders, obesity |
| Services Covered | Body Mass Index (BMI) screening, education and counseling on nutrition and physical activity, prescription drugs that promote weight loss, bariatric surgery |
| State-Level Variation | Coverage for MNT varies by state, some states do not recognize registered dietitian nutritionists as approved providers |
| North Carolina-Specific Coverage | Services offered to pregnant women and people under 21 |
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What You'll Learn
Personalized nutrition plans
Medicaid health plan members can access personalized nutrition coaching at no cost through Foodsmart, a program that works with Medicaid plans across the country. Foodsmart connects members with a registered dietitian who helps create a custom nutrition plan to support common medical conditions like heart conditions, diabetes, cancer, digestive disorders, and obesity. During the initial consultation, the dietitian will ask about current health goals, eating habits, medical and family history, food preferences, and cooking skills to develop realistic and attainable health and nutrition goals. The dietitian will also provide money-saving shopping tips and help apply for SNAP benefits.
Research supports the effectiveness of personalized nutrition plans. A systematic review of 11 studies found that individuals who received personalized nutrition advice were more likely to improve their diets compared to those who received general nutrition guidance. Additionally, a study of over 200 people with prediabetes showed that while both the Mediterranean diet and personalized nutrition plans helped control blood sugar, the personalized approach resulted in greater improvements. Furthermore, large-scale studies suggest that personalized plans can be more effective in managing blood sugar responses in those at risk of developing diabetes.
Overall, personalized nutrition plans offer a tailored approach to improving dietary patterns, lifestyle behaviors, and health-related outcomes. By taking into account individual needs and preferences, these plans can be more effective than generalized dietary guidelines.
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Weight loss programs
Medicaid covers obesity-related services, including weight loss programs, obesity screenings, and bariatric surgery. Obesity screenings are mandatory for beneficiaries under the age of 21, and some states may offer them to those aged 21 and over. These screenings are part of the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit. Additionally, some state Medicaid programs cover weight loss interventions, education, and counseling to promote healthier eating habits and increased physical activity.
Medicaid may also cover prescription weight loss medications, although these are not considered mandatory benefits. The coverage of specific medications can vary by state. Intensive behavioral therapy (IBT) is another element of comprehensive obesity care that may be covered by Medicaid, although the extent of coverage may differ across states.
It is important to note that weight loss surgery covered by Medicaid must be performed at a Bariatric Center of Excellence, and certain criteria must be met. These criteria include completing a medically supervised weight loss program for six months, understanding the necessary dietary and lifestyle changes, and accessing nutritional and psychological services before and after the surgery.
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Nutritionist services
As a Medicaid health plan member, you may be able to access nutritionist services, but this varies depending on where you live. While the federal government does not require Medicaid agencies to provide nutritionist services, some states offer coverage for Medical Nutrition Therapy (MNT) as optional preventive care services. As of 2018, California, Minnesota, Montana, New Jersey, New York, Texas, and Vermont offered some form of Medicaid coverage for the National DPP (a program designed to help prevent or delay Type 2 diabetes). As of July 26, 2020, North Carolina also allowed Medicaid coverage for MNT services for pregnant women and people under 21.
Medicaid coverage for MNT may fall under the category of "other diagnostic, screening, preventive, and rehabilitative services." However, some states do not recognize registered dietitian nutritionists as approved Medicaid providers. To confirm whether nutritionist services are covered in your state, it is recommended to consult the Medicaid office in your state.
If you are enrolled with a Managed Care Organization (MCO), the main delivery system for Medicaid, you may be able to access nutritional counseling through your Medicaid plan. Additionally, Foodsmart is a personal nutrition program that works with Medicaid plans across the country to offer personalized nutrition coaching at no cost to the member. This program connects members with registered dietitians who can help with meal planning, shopping on a budget, and food delivery.
It is important to note that, under the Affordable Care Act, nutrition services are available to all adults at risk for chronic diseases, regardless of their insurance type. This includes Medicaid, Medicare, or private insurance.
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Obesity-related services
Obesity is a serious public health challenge in the United States, with approximately one in three adults and one in six children and adolescents affected. To address this, Medicaid and the Children's Health Insurance Program (CHIP) provide access to screenings and interventions to reduce obesity and promote healthy eating and physical activity.
Medicaid may cover the cost of medically supervised weight loss programs, which are overseen by a healthcare provider or registered dietitian. These programs can include a combination of diet and exercise interventions, as well as medication if necessary. Commercial weight loss programs like Weight Watchers or Jenny Craig are typically not covered by Medicaid, but some states may offer Medicaid-funded weight loss programs or partnerships with commercial programs.
Medicaid may also cover the cost of weight loss surgery, or bariatric surgery, for individuals who meet certain criteria. This surgery is recommended for those with a body mass index (BMI) of 40 or higher, or a BMI of 35 or higher with obesity-related health conditions such as diabetes or high blood pressure. The majority of Medicaid programs cover bariatric surgery, though often with restrictions.
Medicaid-eligible children have access to obesity-related services through the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) program, which includes regular assessments of nutritional status and questions about dietary practices. States are required to cover EPSDT benefits for all eligible children under the age of 21, and many states also choose to cover at least one obesity treatment for adults.
In addition to weight loss programs and surgery, Medicaid may cover obesity medications (OM) and intensive behavioral therapy (IBT). The STOP Obesity Alliance analyzed how states are covering the treatment of obesity in their Medicaid programs, and found that 26 state Medicaid programs covered nutritional assessment and consultation for obesity.
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Food allowances
Medicaid's Foodsmart program connects members with their own registered dietitian, a clinically-trained nutrition expert who is licensed to support common medical conditions like heart conditions, diabetes, cancer, digestive disorders like Celiac or irritable bowel disease, and obesity. Foodsmart's digital app helps members with meal planning, shopping on a budget, and food delivery.
Medicaid and CHIP programs help address the challenge of obesity by providing access to screenings and interventions to reduce obesity and promote healthy eating and physical activity. They can cover a range of services to prevent and reduce obesity, including Body Mass Index (BMI) screening, education and counseling on nutrition and physical activity, prescription drugs that promote weight loss, and, as appropriate, bariatric surgery.
Qualifying participants can earn up to $200 each year to help pay for services offered by PHA providers such as participation in the National Diabetes Prevention Program, fees for a weight management program, a gym membership, healthy lifestyle classes, or nutrition classes or services.
It's important to note that Medicaid coverage for Medical Nutrition Therapy (MNT) varies depending on where you live, and the scope of coverage depends on a range of factors. While MNT isn't expressly outlined as an optional benefit, it could fall into the category of "other diagnostic, screening, preventive, and rehabilitative services." However, some states don't currently recognize registered dietitian nutritionists as approved Medicaid providers.
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Frequently asked questions
Medicaid is a health plan that provides health, prevention, and wellness benefits. The basic plan includes annual physicals, immunizations, most prescriptions, doctor and hospital visits, and more. The enhanced plan is for individuals with disabilities or special health needs.
Medicaid coverage for medical nutrition therapy (MNT) varies depending on where you live. As of July 26, 2020, North Carolina covers MNT services for pregnant women and people aged under 21. Other states offer some form of Medicaid coverage for the National Diabetes Prevention Program (DPP).
To qualify for MNT under Medicaid, you must meet certain criteria based on your age and health status. Adults must have a body mass index (BMI) of 30 or higher or 18.5 or lower, and children must have a BMI in the overweight or underweight category.
