Pediatric Wellness Benefits

Children need food to fuel their bodies and boost brain power. But making smart food and nutrition choices can be hard, especially with so many tempting snacks and sugary foods. You can help your child learn to eat right and your child’s doctor will track their growth and weight gain each year at their well-child visit.

If your child is overweight or obese, he or she may be eligible for extra help with a dietitian to learn about food and nutritional education. Obese is defined as a BMI (body mass index) at or above the 95th percentile for children of the same sex and age. Overweight is defined as a BMI at or above the 85th percentile but less than the 95th percentile. You can calculate your child’s BMI here and you can talk to your kids about their weight without making them feel self-conscious.

Help Is Available
Because Louisiana Blue wants to prevent weight problems before they start, ALL children covered under an eligible policy may have an annual visit with a registered dietitian covered under contract benefits, meaning Louisiana Blue will cover the visit after you pay any applicable deductible, co-insurance or copayment.

Louisiana Blue offers a treatment benefit for children ages 3 to 18 who are diagnosed as overweight or obese and covered under an eligible policy. They are allowed at least four primary care doctor or pediatrician visits and at least four registered dietitian visits. If your child is under a grandfathered, fully insured policy*, registered dietitian visits are covered as contract benefits.

Additionally, children ages 3 to 18 diagnosed with obesity and covered under an eligible policy* are fully covered for 52 visits of intensive treatment with eligible health and behavior programs and professionals. The 52 visits with an in-network provider begin when the child is diagnosed with obesity at his or her annual visit. After the 52 visits, coverage moves to contract benefits. The coverage is a once-in-a-lifetime benefit.

How to Access these Benefits for Your Child
Schedule an appointment with your child's doctor. If you do not have a doctor your child sees regularly, search our directory to find a pediatric or family doctor, or to find a registered dietician.

Download this document and bring it with you to your child's appointment to help your provider correctly code the visit as part of the prevention benefit.

If you have questions about exactly what the benefit includes, please call the customer service phone number on the back of your health plan ID card.

*A grandfathered, fully insured policy is a health insurance policy purchased on or before March 23, 2010. They may not include some rights and protections provided under the Affordable Care Act. A non-grandfathered policy is a health insurance policy purchased after March 23, 2010. They include all rights and protections provided under the Affordable Care Act.