The Challenges of Finances and Insurance Coverage

Article contributed by Jacquelyn Ekern, MS, LPC, and Crystal Karges, MS, RDN, IBCLC.

Eating disorders are complex mental health issues that require professional help and treatment to overcome.  The level of treatment will vary based on the individual and the degree of medical, nutritional, and psychiatric issues that are present.  Regardless the level of treatment needed, whether it is inpatient, residential, or outpatient care, professional help is necessary for preventing the devastating consequences that might result from an eating disorder.

If eating disorders themselves were not complex enough, finding ways to cover the cost of treatment can be overwhelming and discouraging at times.  It is difficult to navigate through various insurance plan options and find the resources needed to finance treatment on any level of care.  Even if you or your loved one has made the decision to seek treatment for an eating disorder, you may find that figuring out how to pay for treatment is a difficult challenge.

It is estimated that only 1 in 10 men and women with eating disorders receive treatment.  Only 35% of individuals that receive treatment for eating disorders get treatment at a specialized facility for eating disorders [1].  With eating disorders having the highest mortality rate of any mental illness, the risk of death is increased when treatment is not sought.  As professional and comprehensive treatment is a crucial part of recovery from an eating disorder, it is helpful to understand the resources that may be available to you and find the ways to cover costs.

Insurance Coverage

With the implementation of the Affordable Care Act (ACA) in the health care system, obtaining private insurance is now more accessible.  While in the past, the insurance market would exclude individuals with pre-existing conditions (such as eating disorders) from health insurance; this is no longer applicable under the new health care law.  However, there are significant variations in private insurance coverage of eating disorders.  If you have private health insurance and seeking coverage for eating disorder treatment, keep the following in mind:

  • Understand your policy:  Investigate your policy further to learn about the care that is offered under your insurance.  It may be helpful to contact your Insurance Company directly and ask specifically about your mental health benefits and/or eating disorder treatment.  This would also be a good time to inquire about coverage limits for treatment under your policy.
  • Search for an in-network provider:  Your insurance company can help you connect with providers that are considered “in-network” with your policy.  Choosing an in-network provider or treatment center will be helpful in covering a greater percentage of treatment costs.  Alternatively, you can work with a treatment center’s admissions staff to determine if your insurance is accepted at the facility of your choice.

Uninsured/Low-Income

If you are seeking treatment for an eating disorder but uninsured or unable to pay privately, there are options that can be helpful in covering costs.  The following are some treatment alternatives that can provide care for eating disorders at a lower cost or sliding-scale basis:

  • Research-based programs through teaching universities or hospitals
  • Non-profit organizations that provide treatment with income-based sliding scales or scholarship funds, such as Project Bliss
  • Counseling departments/wellness centers in schools/universities
  • Community mental health facilities

It is always helpful to contact the admissions staff of any facility you may be interested in to learn more about your financial options.  Options may include payment plans, income-based sliding scales, or Medicare/Medicaid benefits.

Regardless of how you finance your treatment, know that your life and recovery are absolutely WORTH everything.  The consequences of eating disorders are excruciating, and nothing is more valuable than your own life, including any worldly possessions or material wealth.  It is an incredible sacrifice to find and afford comprehensive treatment, but being connected with quality treatment may be the deciding factor in saving your life.  Learn more about how to connect with a treatment center and take the steps you need toward recovery today!

References:

[1]: The Renfrew Center Foundation for Eating Disorders, “Eating Disorders 101 Guide: A Summary of Issues, Statistics and Resources,” 2003

 

Page Last Updated & Reviewed By: Jacquelyn Ekern, MS, LPC on
March 10, 2014
Published on EatingDisorderHope.com, Eating Disorder Resources, Information, Help and Treatment