I will be attending a workshop during the International Eating Disorders Association for Professionals Conference in March, which will focus specifically on the issue of dealing with insurance companies, and how to protect your rights and obtain the coverage you are deserved.
Lisa Kantor, Esq., who will be hosting this workshop, offers the following examples of stupid things that insurance companies have used for excuses to deny coverage for treatment of an eating disorder:
- The client is compliant or non-compliant (both have been used to deny benefits).
- The client has 'sufficient support' at home and therefore doesn't need residential treatment.
- The client is 'chronic' and basically beyond hope.
- The client hasn't tried outpatient treatment first.
Without apology....
Over time I have had my own run-ins with insurance companies and have heard many heartbreaking stories. Occasionally I am reminded that insurance is a business and health care a commodity just like any other. My own experience is that behavioral issues are the poor stepchildof medicine. My favorite reason for being denied care is that I am not sick enough to pass the "necessity" test. That is, I am not physically sick enough to warrant treatment (along with the ever popular "you're out of benefits"). The way I see it,that is excellent motivation to let ED run rampant until you are so sick that the insurance company is moved by threats of lawsuits. How many people have to die before the dangers of eating disorders are recognized and addressed?
ReplyDeleteThanks Mara...you make an excellent point, and a tragic one. I would guess that 90% of the people I have talked with about this have been told at one time or another that they 'aren't sick enough'...exactly the same as saying lose more weight or b/p more, etc. I am eager to hear more at the Conference that will hopefully prove to be ammunition for people who need help.
ReplyDelete