Archive for October 21st, 2012

Insurance Coverage Lacking for Eating Disorders

Sunday, October 21st, 2012

If you or a family member have ever suffered from an eating disorder, you probably know how difficult it can be to get your health insurance company to pay for treatment.  Kaiser Health News discusses this in an article by Shefail S. Kulkarni entitled “Patients Often Find Getting Coverage for Eating Disorders is Tough.”  They talk about a 44-year old woman who has been fighting binge eating disorder for two decades.  Since eating disorders like this, anorexia, and bulimia are mental health conditions; coverage is very individualized and hard to classify.

Unfortunately, many people don’t get consistent treatment because their health insurance either doesn’t cover eating disorder treatment or only covers partial or short-term treatment.  As with most mental health disorders, treatment can take a long time, sometimes the rest of one’s life.  It takes comprehensive care from a primary doctor, nutritionist, therapist, and psychiatrist to treat most eating disorders.  Patients say that insurance companies are less than generous with their coverage in these areas compared to insurance coverage for physical ailments.  The Eating Disorder Coalition fought hard to get eating disorders classified as “essential health benefits” that must be covered per the Affordable Care Act.  They were not successful.

Fourteen million people are suffering from eating disorders right now.  But because health insurance companies are suffering with soaring health care costs, eating disorder coverage is often one of the first things to get dropped from insurance.  While insurers don’t think this coverage is essential, almost 100% of eating disorder specialists say that denial of coverage for people battling anorexia puts them in a life-threatening situation.  Insurance companies argue that since there is not a clear cut treatment program for eating disorders, it is more difficult to provide blanket coverage.  Parents of autistic children have run into the same kinds of problems when it comes to coverage of their children’s treatment.  After fighting insurers, coverage for autism treatment is now mandated in 31 states.

Eating disorder treatment ranges from nutritionist appointments, group therapy, and antidepressants to hospitalization and admittance to mental health facilities.  Once such facility’s worker said that insurance companies are much more likely to pay for treatment for mood disorders than they are for eating disorders.  Insurers also are quicker to authorize longer stays when it comes to mood disorder treatment.  Patients believe a lot of the problem is with the stigma attached to eating disorders.  It seems to many outsiders that someone should just eat something or stop eating, but the mental health issue is far beyond allowing patients to do that.  There is definitely spotty coverage when it comes to eating disorders, so check with your personal insurer to see what services you can receive if you need eating disorder treatment.