Should Insurance Cover Genetic Obesity Treatments?

What is Genetic Obesity?

Genetic obesity refers to weight gain caused by the influence of genes or genetic factors. Generally, obesity is linked to lifestyle problems such as poor diet, lack of exercise and unhealthy eating habits. Though it is true in many cases, genetics does play a crucial role. When genetics influences the weight and fat distribution, even a healthier lifestyle may not help.

The diagnosis of genetic obesity requires the medical professional to run a genetic test on patients to understand the root cause of gene mutations affecting the metabolism and appetite. Patients with genetic obesity often require specialised treatment apart from lifestyle changes. This includes:

• Setmelanotide injections, specifically for obesity caused by MC4R mutations
• Metreleptin, for obesity caused by leptin deficiency
• Gene-targeted treatments and therapies
• Bariatric surgery is an effective treatment for severe cases of genetic obesity.

The treatment and the cost of treatment can vary for each patient depending on the severity, complexity and many other factors.

Obesity is a growing serious healthcare challenge in India. Even our Prime Minister Narendra Modi has addressed the concerns of growing obesity in India, and he has also emphasised a healthier lifestyle.

Health Insurance Coverage for Genetic Obesity Treatment in the Current Landscape

Despite advancements in the healthcare field, the health insurance coverage for genetic obesity treatments remains scarce. There are only a few health insurance providers in India that offer coverage for genetic obesity treatments under specific plans. For example, TATA AIG obesity insurance and BMI insurance from Care Health Insurance. These policies can cover obesity treatments like bariatric surgery, medical expenses, behavioural therapy charges and more.

Genetic obesity treatments are not generally covered under the standard health insurance plan offered by insurance companies. Most of the insurance companies in India view this as a cosmetic concern rather than a medical necessity or a condition.

At Jio Insurance Broking, you can explore various health insurance plans, including obesity insurance, offered by all popular health insurance companies in India. You can compare the scope of coverage, features and cost on a side-by-side basis to choose the most suitable one.

Debate on Health Insurance Cover for Genetic Obesity Treatments

Here are a few important things to consider in the debate of whether genetic obesity treatment should be covered under health insurance or not.

Recognition of genetic obesity as a medical condition

Genetic obesity, with clear biological underpinnings or genetic influence, reinforces obesity’s status as a medical condition rather than a lifestyle choice.

Necessity to prevent obesity-related complications

Obesity is linked to many health complications such as hypertension, heart disease, obesity, asthma, type 2 diabetes, high cholesterol, kidney ailments, osteoarthritis, sleep apnea and more. Understanding the medical necessity to prevent these comorbidities linked to genetic obesity is extremely important to state an argument that there is an absolute need to get health insurance coverage for effective treatment of genetic obesity.

Long-term well-being and cost benefit

Anti-obesity drugs, bariatric surgeries and other treatments for genetic obesity are quite expensive. The complications related to obesity can impact one’s long-term health and make treatment expensive. This point needs to be considered in the argument related to the inclusion of genetic obesity treatment coverage under health insurance. Having coverage can make treatment accessible for many and improve the quality of life.

However, we cannot ignore the challenges and barriers while arguing for the inclusion of genetic obesity treatment coverage under health insurance. This includes high treatment costs, expensive new genetic therapies, legal restrictions, and varied coverage offered by the specific plans. Concerns regarding increased premium cost, expensive treatments putting strain on the insurance pool, and potential misuse of coverage cannot be ignored.

Conclusion

To conclude, Obesity is a serious health challenge and a rising epidemic in the country. Socioeconomic barriers, costly treatments and limited insurance access can be one of the major reasons for the unmet need and rising cases of untreated genetic obesity. After considering the challenges and legal restrictions, it is important to come to a positive middle ground with strict eligibility, government subsidy and preventive care incentives. Insurance coverage for genetic obesity is not just about financial security, but also about reducing long-term health risks and recognising obesity as a medical condition.