Obesity affects a significant portion of the American adult population, estimated to be around one in three. Recognizing the critical link between weight management and overall health, Blue Cross Blue Shield (BCBS) offers a variety of programs and resources to assist members in achieving their weight loss and wellness goals. These programs range from digital tools and health coaching to coverage for weight-loss medications and surgical procedures.
Comprehensive Weight Management Programs
BCBS provides access to a range of weight management programs designed to cater to diverse needs and preferences. These programs often incorporate personalized action plans, nutritional guidance, and ongoing support to help members track progress and achieve sustainable results.
Weight Management Program by Livongo
The Weight Management Program by Livongo® offers eligible members a digital scale and continuous support to help them manage their weight and improve their overall health. This program is available to members 13 and older who meet specific criteria based on pharmacy or medical claims and BMI. Members living overseas must have a valid APO, DPO or FPO address.
Wondr Health
Wondr Health is a clinical behavioral weight management program focused on weight loss and diabetes prevention. It emphasizes the importance of when and how you eat, rather than just what you eat. This 10-week online program uses video lessons and interactive tools to teach behavioral skills necessary for long-term weight management. State Health Plan members, including spouses and dependent children ages 18 and older, as well as Medicare-primary members, are eligible to apply, although certain medical conditions or BMIs may prevent participation. More information is available at www.wondrhealth.com/PEBA.
Health Coaching
BlueCross offers health coaching to help members meet their weight management goals. The program assists members ages 18 and older in achieving weight-loss goals through small, sustainable changes in their daily lives. Upon enrollment, members receive information about weight management and complete a confidential survey to help a registered nurse tailor the program to their specific needs.
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Weight Management for Kids and Teens
BlueCross also provides a confidential weight management program for overweight and obese dependents ages 2-17. This program educates children and their parents about healthy habits and encourages them to work with their doctor on weight management. Enrollees receive a parent’s guide and tailored educational materials, along with a personal health coach who provides education and support. To connect with a coach, members can call 855-838-5897 and select Option 3.
Disease Prevention and Reversal Programs
Recognizing the interconnectedness of weight and chronic conditions, BCBS offers programs that integrate weight management into broader health initiatives.
Virta Health
Virta is a diabetes care program that utilizes technology and nutrition counseling for weight loss to help reverse Type 2 diabetes. Participants can lower and control their blood sugar levels while reducing or eliminating diabetes medication and losing weight. The program is available at no cost to eligible State Health Plan primary members. Learn more and apply at virtahealth.com/join/peba.
Diabetes Health Education
Diabetes health education is offered through certified diabetes educators at no cost to State Health Plan primary members at a network provider. Diabetes education trains diabetics to manage their condition to avoid disease-related complications. People who receive diabetes education are more likely to use primary care and preventive services, take medications as prescribed, and control their blood glucose, blood pressure and cholesterol levels. Members can visit a network provider for more information or work with a BlueCross health coach at no cost.
Hello Heart
Hello Heart is a program designed to help participants track, understand, and manage their heart health. It includes a free blood pressure monitor that connects to a smartphone app. The program is available at no cost to eligible State Health Plan primary members, who can enroll at join.helloheart.com/PEBA2. Members can also work with a BlueCross health coach to better understand and manage their heart condition.
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Dr. Dean Ornish’s Program for Reversing Heart Disease®
Dr. Dean Ornish’s Program for Reversing Heart Disease® is scientifically proven to reverse the progression of heart disease by optimizing nutrition, stress management, fitness, and social support. This program is available to Blue Shield of California commercial HMO and PPO plan members.
Additional Resources and Tools
BCBS provides a variety of additional resources and tools to support members in their weight management journey.
Blue365
Blue365 is a discount program available to State Health Plan members offered by BlueCross. It offers discounts on health centers, weight loss and nutrition programs, wearable health-trackers, licensed acupuncturists, massage therapists and fitness clubs. For more information, members can log in to their My Health Toolkit account.
Personify Health
State Health Plan members have access to Personify Health (Personify), a digital health platform designed to help members adopt changes in behavior that can lower health risks. Members can sync their personal fitness device and join group challenges. To enroll, members can log in to their My Health Toolkit account to access Personify and take the brief health survey.
FEP Blue Focus® Rewards
FEP Blue Focus® members can get rewarded for having their annual physical every year.
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Coverage for Weight-Loss Medications and Procedures
BCBS recognizes that medical interventions may be necessary for some individuals struggling with obesity.
Weight-Loss Drug Prescriptions
BCBS covers weight-loss drug prescriptions to treat obesity for Service Benefit Plan members who meet eligibility criteria and get prior approval. In addition to good nutrition and physical activity, many FDA-approved weight-loss medications can help reduce weight by at least 5%. Beginning January 1, 2025, the tiers for some weight loss GLP-1 drugs will change for members with FEP Blue Standard® and FEP Blue Basic® plans.
Procedures for Morbid Obesity
FEP also covers procedures to treat morbid obesity, with prior approval required for surgery.
The Importance of Weight Management
Being overweight or obese significantly increases a person’s risk of diseases and other health problems, such as heart disease, diabetes, high blood pressure and high cholesterol. Maintaining a healthy weight is crucial for overall well-being, including heart health.