Saturday, August 21, 2010

Insurance Woes?

What is it that is preventing you from getting help to recovery from an eating disorder?
Based on what I encounter on a daily basis, I would expect that for most people, it involves lack of insurance, lack of adequate resources, and/or the fact that if they do have insurance, coverage for eating disorder treatment is limited, if offered at all.
As we all are aware, many changes are occurring on the National scene in terms of healthcare, the details of which none of us knows for certain.
I am interested in any experiences YOU have had with insurance, where you were denied treatment, or adequate length of treatment, which could have helped you to fully recover.
Insurance companies often develop their own criteria, which may or may not be [loosely] based on the APA guidelines for eating disorder treatment. Sadly enough, THEY get to decide how much, and how long they will provide coverage for treatment. And the 'professionals' who make these decisions are often not educated, or interested in becoming educated about what type of treatment works, or why the treatment is vital for someone to recover.
Would a person being treated for cancer be told that insurance would cover 5 doses of chemotherapy, when a regimen of 10 treatments is the proven course to take? Maybe, but not likely.
I hear repeatedly that a person is not 'sick' enough [paraphrased] to be in treatment, unless they are medically unstable, or suicidal.
I suspect that any of you who are reading this realize, that an eating disorder is complex, and involves much more than reaching a stable 'medical' status. Sigh....
What is YOUR experience? How can you fight for what you need?
If you would like to share, please leave a comment, or feel free to email me at
Never give up!!
Without apology....♥


  1. For my first inpatient stay in April '96 I must have had pretty good insurance because the treatment center I went to worked with my insurance and was able to get my entire stay covered. I was in intensive IP for 45 days and then a step down program for 90 days. Any outpatient appointments with therapist or dietitians I had to pay out of pocked but my MD and Psychiatrist were covered with a nominal copay. My second inpatient stay in January '98 I had to pay for entirely on my own but I figured, mostly because I was a single parent with 3 kids to raise, that getting treatment was well worth it....who can put a dollar value on a life? The treatment center worked out a payment plan and I ended up making monthly payments until 4 years ago. Every month I was reminded how important it was to continue on my recovery journey. Not to say that it was perfect, but with that reminder I think I fought harder. Again any therapy I had to pay for on my own. My brother was addicted to drugs and my mom had to mortgage her house to pay for his treatment. I think mental health coverage in this country is very poor as far as insurance is concerned, even with the new parity laws.

  2. clh...thank you for your input...I'm so glad you are doing well...♥

  3. My insurance only covered my first 6 full weeks of treatment and then after that they only covered 2 days a week so that's all I went until I graduated. after that my insurance never covered my outpatient or psychiatrist appointments. had to pay them out of pocket. now I only have to pay a copay for my new psychiatrist but I only get a limited amount of sessions.

  4. I can't even begin to tell you the horror stories I have heard. My own horror story is that, in a state with a "parity" law (that is that mental health coverage must be the same as medical coverage)my treatment was limited in a variety of ways because of a legal loophole. Several years in a row we paid over $15,000 each year out of pocket even with health care insurance some would consider enviable.

    For me it also brings up the subject of "sick enough" since often the sole criteria were lab tests. The professionals who practically begged the insurer to authorize treatment were routinely ignored because I was not sick enough. That deepened my denial and often led to my feeling that I was indeed not sick at all.

    The system is hopelessly broken and people are suffering (sometimes dying) because of it.

  5. Mara,
    Sadly, this is a common occurrence, which ends leaving people without the length of treatment they need. I also see that this sends the message that a person's needs are not valid. Hopefully, we can all work together to expose this fallacy. Thank you for your input. ♥