Health Insurance for Eating Disorder Treatment: Fighting For Coverage

Man working on EAP paperwork

Author: Jacquelyn Ekern, MS, LPC, CEO @ Eating Disorder Hope

Eating disorders continue to have the highest mortality rate of all mental illnesses, impacting individuals in multiple aspects – many that are life threatening. Comprehensive treatment provided by eating disorder specialists has been shown to be the most effective method for intervention and recovery from these psychiatric illnesses, including anorexia nervosa, bulimia nervosa, and binge eating disorder.

With countless people struggling with these deadly diseases, connecting to adequate treatment is needed more than ever before. However, eating disorder sufferers face many hurdles in their quest to obtain the treatment they need, with one of the major obstacles being sufficient finances.

Financing Eating Disorder Treatment

Depending on the severity of the illness, eating disorder treatment can range in cost from $500 to $3000 per day, and many individuals seeking treatment may require a stay that extends anywhere from three to six months. Sadly, eating disorder treatment is often cut short prematurely, primarily for lack of eating disorder coverage from health insurance companies and an inability to afford treatment otherwise. Most insurance companies will not provide coverage for long-term treatment, which is often required for full recovery and healing.

Fighting for your life might also include advocating for your treatment coverage and appealing to your health insurance carrier for medically necessary interventions. If you have found yourself in the position where your treatment has either been denied or prematurely shortened by the decision of your health insurance carrier, it is important to know that there are options for appealing this decision and ways to fight for needed treatment.

Working With a Treatment Advocate

Insurance paperwork and calculator laying on a deskNavigating through the process of an insurance appeal can be overwhelming and confusing, and it is crucial to seek out professional help as appropriate when needed. Specialized legal professionals can support your appeal and guide you in the process of obtaining greater coverage from your health insurance.

Important aspects that may be reviewed in your appeal case include 1) the use of discretionary clauses by insurance companies and the attempt to use deferential shields in court, and 2) the criteria used for deciding the claim. A legal professional can be helpful in closely examining these specific aspects of an insurance company’s decision regarding coverage and determining if this is something that can be challenged and overturned.

Whatever your present situation might be, understand that your life is invaluable, and you are not alone in your battle for treatment coverage and recovery. Many resources are available and at your disposal; these should be utilized effectively to determine benefits available for eating disorder treatment.

Jacquelyn EkernAbout the author: Jacquelyn Ekern, MS, LPC founded Eating Disorder Hope in 2005, driven by a profound desire to help those struggling with anorexia, bulimia and binge-eating disorder. This passion resulted from her battle with, and recovery from, an eating disorder. As president, Jacquelyn manages Ekern Enterprises, Inc. and the Eating Disorder Hope website. In addition, she is a fully licensed therapist with a closed private counseling practice specializing in the treatment of eating disorders.

Jacquelyn has a Bachelor of Science in Human Services degree from The University of Phoenix and a Masters degree in Counseling/Psychology, from Capella University. She has extensive experience in the eating disorder field including advanced education in psychology, participation and contributions to additional eating disorder groups, symposiums, and professional associations. She is a member of the National Eating Disorder Association (NEDA), Academy of Eating Disorders (AED), the Eating Disorders Coalition (EDC) and the International Association of Eating Disorder Professionals (iaedp).

Jacquelyn enjoys art, working out, walking her golden retriever “Cowgirl”, reading, painting and time with family.
Although Eating Disorder Hope was founded by Jacquelyn Ekern, this organization would not be possible without support from our generous sponsors.

The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Last Updated & Reviewed By: Jacquelyn Ekern, MS, LPC on June 20, 2016
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Although Eating Disorder Hope was founded by Jacquelyn Ekern, this organization would not be possible without the support from our generous sponsors.