Does health insurance cover weight loss?  

Most Australians have tried a diet at some point in their lives, which means many have discovered that crash dieting and programs which promise quick results are rarely successful in the long term. According to the Australian Bureau of Statistics (ABS) data, more than 2.3 million Australians over the age of 15 were on a weight loss diet in 2011-2012 (the most recent data available).  

Yet experts say that the secret to achieving a healthy weight – which isn’t a secret, really – is gradual, steady weight loss through healthy eating and regular exercise. The good news is that your health insurer can help you along the way. 

Here’s how health insurance can help you lose weight.   

Are weight-loss programs available from health insurers? 

If you need to lose weight for medical reasons, such as to manage a long-term condition like osteoarthritis or diabetes, many health insurers partner with coaching programs that may help. For example, both HBF and Uni Health allow you to claim the cost of recognised weight management programs including the CSIRO Total Wellbeing Diet.  

Depending on the insurer, this could involve advice and coaching on exercise and nutrition, as well as personalised tracking through video or phone consultations.  

The best way to find out what’s available for you is by searching your insurer’s website or giving them a call.  

Can health insurance help me be more active to support my weight loss?  

Exercise is one of the key components of weight management, and yes, health insurance can support you with that. Many insurers will reimburse your gym membership or exercise training costs if you have a chronic condition, such as diabetes. To be eligible, you may need to have the right level of cover and get a healthcare professional to sign your insurer’s form – ask your insurer about their process.  

Plus, some insurers go a step further, and even reward you for being physically active and eating well – get the lowdown here. 

Does health insurance pay for weight loss surgery? 

If your doctor has recommended you have weight loss surgery, such as a gastric band, gastric sleeve or gastric bypass procedure, your health insurer may cover some of your costs. This can come in handy, too, since a gastric band procedure could cost between $20,000 and $25,000 (keep in mind prices will vary). 

You’ll need to have a policy that covers Weight Loss Surgery (which usually means a Gold tier policy, but some insurers may offer it in lower tiers) and have served any waiting periods. You’ll also need to meet certain medical criteria, including having a BMI (body mass index) of 35 or more, and have a health condition. In other words, the procedure needs to be medically necessary, and not for cosmetic reasons.  

Keep in mind that even if you’re covered by health insurance, there may still be a Gap to pay.  

What is a Gap?

How do I find health insurance that covers weight loss? 

If your insurer isn’t supporting your weight loss goals as much as you would like, why not look for a better deal? We’ve made it quick and easy to search for health insurance with our Calculator, and it’s the only one in Australia that searches every single policy on the market. It’s free to use and you don’t need to provide your contact details.  

When searching for Hospital Cover, make sure you tick ‘Weight Loss Surgery’ in the Clinical Categories box so that you’re comparing policies which will cover this procedure. When you get the results, you can use the ‘edit’ option to turn ‘Weight Loss Surgery’ on and off, and see how that will affect premiums.  

You can use our Calculator to compare your existing policy with others on the market, or look for a brand new policy.   

Trudie McConnochie

Writer and Researcher

Knowledge is power – that’s the guiding principle behind everything Trudie writes, and it’s a philosophy she brings to her work at healthslips.com.au. By breaking down complex information into easy-to-understand blogs and stories, she aims to empower Australians to make the best choices and an informed decision around private health insurance.

Trudie understands firsthand some of the complexity of private health insurance having moved to Australia from New Zealand and having to navigate a vastly different public healthcare system and health insurance structure.

Trudie holds a Bachelor of Communication Studies (journalism major) from the Auckland University of Technology.

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