Healthy Texas Women does not cover weight loss. The program will not pay for weight loss medications, bariatric surgery, or a structured weight loss program. It will cover obesity screening as part of a preventive visit, and it will pay for medical nutrition therapy with a registered dietitian, which is the closest thing to weight-related care available through the program.
What HTW Will Pay for That Touches Weight
HTW is a family planning and women’s health program, and its benefits are built around reproductive and maternal health rather than general medical care.1Healthy Texas Women. About Healthy Texas Women Two services inside that scope touch on weight.
The first is obesity screening. It’s listed as one of the “preconception health screenings,” alongside screenings for hypertension, diabetes, high cholesterol, smoking, and mental health conditions.2TMHP. HTW Program Handbook, February 2025 A provider can measure your BMI and flag obesity during a covered visit. Screening is not treatment, though, and obesity is not on the list of chronic conditions HTW treats on an ongoing basis.3TMHP. HTW Program Handbook, March 2023
The second is medical nutrition therapy, billed under procedure codes 97802, 97803, and 97804.4TMHP. HTW Program Handbook, February 2026 Those codes cover individualized nutrition assessment and counseling with a registered dietitian, as well as group nutrition sessions.5AAPC. Coding Obesity and Medical Nutrition Therapy Sessions can be delivered by telemedicine.2TMHP. HTW Program Handbook, February 2025 HTW won’t fund a weight loss program, but it will pay a dietitian to work with you on your eating.
What’s Excluded
Weight loss medications are not covered. The HTW handbook’s drugs and supplies section focuses on contraceptives, immunizations, and drugs for treatable chronic conditions like hypertension and diabetes.2TMHP. HTW Program Handbook, February 2025 GLP-1 drugs such as Wegovy and Saxenda are excluded from Texas Medicaid for obesity control indications under Texas Administrative Code Rule ยง354.1923, and because HTW’s drug list draws from the Medicaid formulary, that exclusion carries over.6Texas HHS. Drug Utilization Review Board Agenda, October 2024
Bariatric surgery isn’t mentioned in the HTW handbook at all. If a provider identifies a health issue outside HTW’s scope, the guidance is to refer you elsewhere, and you may have to pay for those services yourself.7Healthy Texas Women. HTW Benefits Providers may also bill clients directly for services that fall outside HTW benefits.2TMHP. HTW Program Handbook, February 2025 The program’s own summary states plainly: “This program pays only for the services listed.”
Does the July 2026 Drug Expansion Change This
Starting July 1, 2026, HTW’s drug coverage expands to include all Medicaid-eligible drugs within the healthcare categories the program already covers, as part of its transition from state funding to Medicaid funding.8Texas Vendor Drug Program. Reminder: Healthy Texas Women Drug Expansion and New Prior Authorizations Begins July 1, 2026 The Texas Medicaid Preferred Drug List and clinical prior authorization requirements will also apply.9TMHP. Expanded Drug List and New Prior Authorizations for HTW Effective July 1, 2026
The important phrase is “within the healthcare categories already covered by HTW.” Those categories are women’s health and family planning, postpartum depression, cardiovascular and coronary conditions, and substance use disorders.9TMHP. Expanded Drug List and New Prior Authorizations for HTW Effective July 1, 2026 Obesity treatment isn’t one of them. And because Texas Medicaid itself excludes drugs prescribed for obesity control, the expansion is unlikely to open a path to weight loss medications through HTW.6Texas HHS. Drug Utilization Review Board Agenda, October 2024
Conditions Related to Weight That HTW Does Treat
The program treats several conditions that often come up alongside weight concerns. Screening and ongoing treatment for hypertension, diabetes, and high cholesterol are covered benefits.7Healthy Texas Women. HTW Benefits Medications for those conditions have been on the HTW drug formulary since July 1, 2016, and can be filled at any Medicaid-participating pharmacy.10TCHMB. Healthy Texas Women
If you’re within 12 months of a pregnancy ending, HTW Plus adds further benefits: treatment for cardiovascular and coronary conditions with imaging, blood pressure monitoring, and related medications; diabetes monitoring supplies; mental health services including psychotherapy; and substance use disorder treatment including medication-assisted treatment.11TMHP. HTW Plus Services Available September 1, 202012Healthy Texas Women. HTW Plus Provider Fact Sheet There’s no separate application; eligibility is determined automatically when you tell HTW your pregnancy ended in the past 12 months.13Healthy Texas Women. How to Apply for HTW
Where to Look Outside HTW
Full Texas Medicaid coverage for weight-related care is narrower than many people expect, but it isn’t zero. Medicaid covers one adult preventive visit per year that can include obesity screening and behavioral counseling, though those are bundled into the visit rather than billed separately. Nutritional therapy and behavioral assessment for adults are generally not covered outside the TX Health Steps program for people under 21.14GWU Stop Obesity Alliance. Medicaid Obesity Coverage, Texas
Texas Medicaid does cover bariatric surgery with prior authorization for patients meeting specific criteria, generally a BMI above 35 with a serious comorbidity, along with nutritional and psychological evaluations and documentation of previous unsuccessful weight loss attempts. Surgery is not approved when weight loss alone is the goal. Some Medicaid managed care organizations also offer value-added benefits like case management for members with obesity, or discounted access to nutrition and physical activity programs.14GWU Stop Obesity Alliance. Medicaid Obesity Coverage, Texas None of those broader Medicaid pathways run through HTW itself, so a referral out of the program is the route.