Independent coverage reference
Whether your plan covers weight loss treatment, and what it takes
Covered Weight reads the policy documents that decide whether a health plan pays for obesity treatment, and publishes what each one says with a quote from it. Which document governs your case depends on who pays your claims, so the first thing this site does is help you work that out.
4 of 51 jurisdictions are published. The rest open the document checker until their records clear the accuracy checks.
Not sure which plan you are on? That is the question that decides everything else.
Find the document that decides your coverage
Answered in your browser. Nothing you type is sent anywhere.
Source records on file for 51 of 51 jurisdictions, read through Q1 2026. Every fact names the document it came from, the section it sits in, and the date we read it. No paid placements anywhere on this site.
Start here
Start with who pays your claims
Eight kinds of plan pay for healthcare in the United States and only some of them follow rules a state sets. Pick the one on your card and this site sends you to the document that decides your case.
Most readers
Reading the documents, jurisdiction by jurisdiction
608 sourced records across 51 jurisdictions.
4 of 51 jurisdictions are published so far. Each record on this site names the document it came from, its publisher, and the date it was read.
- Benchmark records
- 50 of 51
- Utilization records
- 51 of 51
Essential health benefits benchmark documents on file.
State Drug Utilization Data, Q1 2026.
- Published. Pages are open, with every fact tied to its document.
- Records on file, not published. The source documents are recorded and are still clearing the accuracy checks.
Free tools
Free coverage tools
One tool, because there is one question this site can answer about your own plan without reading your documents. It runs in your browser and sends nothing anywhere.
Start by finding out which document governs your plan
Everything else follows from it. A state program publishes its own rules. A marketplace plan is measured against a state benchmark. An employer plan that pays claims out of the employer's own funds sets its own rules, and no state rule reaches it.
What it gives you
- The document that governs your plan, named, and how to get a copy of it.
- Whether any rule your state sets reaches that plan at all.
- Which body hears an appeal, and the question to ask the office that answers.
- A one-page sheet you can print and take to an appointment.
It does not predict whether your claim will be approved, and it does not compare treatments. Those are decisions for the plan that pays and for a licensed clinician who knows your history.
The distinction that decides
What your plan type means
Two plans with the same insurer name on the card can follow different law. What separates them is who bears the risk, and that decides which document a coverage question is settled by.
| If your coverage is | The document that decides | Do state insurance rules reach it |
|---|---|---|
| Self-funded employer planEmployer plan that pays its own claims | your employer's plan document and Summary Plan Description | No state insurance rule reaches this plan |
| Fully-insured employer planEmployer plan bought from an insurance company | the insurance policy and its certificate of coverage, plus your state's insurance rules | State insurance rules reach this plan |
| Marketplace planA plan bought on the health insurance marketplace | your plan's evidence of coverage, on top of your state's benchmark plan | State insurance rules reach this plan |
| MedicaidMedicaid, including a Medicaid managed care plan | your state's preferred drug list and provider manual, plus your managed care plan's formulary if you have one | State insurance rules reach this plan |
| MedicareMedicare, including a Part D drug plan or a Medicare Advantage plan | your Part D plan's formulary, sitting under the federal definition of a covered Part D drug | No state insurance rule reaches this plan |
| TRICARE or VATRICARE or VA health care | the federal benefit regulation, plus the TRICARE or VA formulary | No state insurance rule reaches this plan |
| State employee planA state or local government employee health plan | the plan's benefit booklet, adopted by the state or local government that sponsors it | Whether state rules reach it depends on the state |
| No planNo health plan right now | no plan document, so price is the whole question | No state insurance rule reaches this plan |
This reads which document governs each plan class and how far state insurance rules reach it for all 51 jurisdictions. Nothing in this table says whether a treatment is covered. That is a per-document, per-jurisdiction fact and it lives on the pages that can show their sources.
Where a denial goes next is decided the same way. The appeal forum for each of these classes sits in one table with the federal rule that puts it there, because six of the eight appeal to a federal body rather than to a state insurance department.
The documents behind the reach column
The documents behind the reach columnThe 7 documents this page was read from
- United States Code, Title 29 (Labor), Chapter 18 (Employee Retirement Income Security Program)Office of the Law Revision Counsel, U.S. House of Representatives · Section 1144. Other laws, subsection (a) Supersedure; effective date · Read Aug 3, 2026
- United States Code, Title 29 (Labor), Chapter 18 (Employee Retirement Income Security Program)Office of the Law Revision Counsel, U.S. House of Representatives · Section 1144. Other laws, subsection (b)(2)(A) · Read Aug 3, 2026
- Code of Federal Regulations, Title 45, Part 156 (Health Insurance Issuer Standards Under the Affordable Care Act, Including Standards Related to Exchanges)U.S. Government Publishing Office, Electronic Code of Federal Regulations · Section 156.115 Provision of EHB, paragraph (a)(1) · Read Aug 3, 2026
- United States Code, Title 42 (The Public Health and Welfare), Chapter 7, Subchapter XIX (Grants to States for Medical Assistance Programs)Office of the Law Revision Counsel, U.S. House of Representatives · Section 1396r-8. Payment for covered outpatient drugs, subsection (d)(2) List of drugs subject to restriction · Read Aug 3, 2026
- United States Code, Title 42 (The Public Health and Welfare), Chapter 7, Subchapter XVIII, Part D (Voluntary Prescription Drug Benefit Program)Office of the Law Revision Counsel, U.S. House of Representatives · Section 1395w-102. Prescription drug benefits, subsection (e)(2)(A) In general · Read Aug 3, 2026
- Code of Federal Regulations, Title 32, Part 199 (Civilian Health and Medical Program of the Uniformed Services (CHAMPUS))U.S. Government Publishing Office, Electronic Code of Federal Regulations · Section 199.4 Basic program benefits, paragraph (g)(28) Obesity, weight reduction · Read Aug 3, 2026
- United States Code, Title 29 (Labor), Chapter 18 (Employee Retirement Income Security Program)Office of the Law Revision Counsel, U.S. House of Representatives · Section 1003. Coverage, subsection (b) Exceptions for certain plans · Read Aug 3, 2026
One answer for the whole country
Popular coverage questions
Four questions do not depend on where you live, so they get one page each rather than fifty.

My employer plan excludes it. Can they do that?
A plan that pays claims out of the employer's own funds follows its own plan document, and federal law puts state insurance mandates out of reach. This page names the document and who has to hand you a copy.
Read it

What goes in a prior authorization request?
Every item a plan asks for before it will decide, who supplies each one, and the order they are usually requested in. Written to be printed and worked through.
Read it

They said no. Who reviews the appeal?
The forum depends on who pays your claims, not on where you live, and six of the eight plan classes appeal to a federal body. One row per class, each with the federal rule behind it.
Read it

What does it cost with no plan paying?
The four channels that publish a price, and the question that gets a number out of each of them. This page prints no dollar figure it cannot cite.
Read it
Articles
Latest from Covered Weight
No articles yet, and that is the order this site was built in.
The reference comes first. An article that explains a coverage rule is only worth reading if the rule behind it has been read at its source and can be quoted, so the document corpus is being built before the writing about it starts. Articles will appear here with the date they were published and the date their facts were last checked.
Two pages are worth reading before the first article lands. How we read a coverage policy sets out the document hierarchy and the status labels this site uses, and the prior authorization checklist is a working document you can print.
Method
How we read the documents
Three commitments, all of them checkable by a reader rather than asserted by us.
Where a document is silent, the page says so and names who to ask instead of guessing. A record marked as not published carries the evidence of the search that found nothing and a route to the office that can answer, because an absence somebody looked for is a different fact from a blank cell.
Common questions
Who publishes this site?
Covered Weight is published by Amenti Labs LLC. It is not a healthcare provider, a pharmacy, an insurance company, or an insurance broker, and it is not affiliated with any health plan or with any state or federal agency.
Where do the coverage facts come from?
From the policy documents themselves: state preferred drug lists, provider manuals, benchmark plan documents, medical policy bulletins, and federal statute and agency publications. Each fact cites its document by title and section, with a quote from it and the date we read it.
Why does this site not just tell me whether I am covered?
Because it cannot know. The same insurer sells many plans, and an employer that pays claims from its own funds sets its own rules. What a published document says and what your plan pays for are two different questions, and only your plan documents answer the second one.
How does a state get published?
It opens only after its records pass every accuracy check, which includes naming the document behind each fact and quoting the line the fact came from. Records go on file well before a page opens, so the map on this page shows three states: published, records on file, and nothing recorded yet. Publishing a page before its sources clear those checks is the thing this site exists not to do.
How often is this updated?
Every fact carries the date it was read, and the whole corpus is re-verified every January and July, when formularies and medical policies reset. A fact that is past its review date is flagged rather than left to age quietly.