Insurance Issues

Problems Getting Treatment?

Finding appropriate treatment and being able to pay for it is almost always a battle. Chances are, you’ll find yourself running into a few roadblocks along the way. On this page are a few suggestions for dealing with some of those roadblocks.

To join us in fighting for better insurance coverage see our activism information below.

 

Dealing With Insurance Issues

ED treatment is expensive, so your insurance company wants to avoid paying for treatment if it can. The Emily Program Foundation has some excellent info on the tricks that insurance companies use, and how you can beat them at their own game.

ANAD (Anorexia Nervosa and Associated Disorders) offers updates on current news about legislation that affects insurance coverage for Eating Disorders. You can also sign up to participate in advocacy efforts.

The National Eating Disorders Association has an excellent contents that provides people with facts based in current academic research, which can be used as ammunition when arguing with insurance companies about whether or not treatment is “necessary.”

  • Sometimes, a doctor can get treatment covered under a diagnosis other than “eating disorder” insurance companies seem much more willing to cover treatment for depression, bipolar disorder, anxiety, etc.
  • School counseling centers are a good place to start. Even if they can’t help you, they can find someone who can, and they take your ability to pay into consideration.
  • Look in newspapers and online for support groups run by ANAD, OA, and other organizations.
  • Look for the community mental health services provider in your area. Though they may not be specifically trained in the area of eating disorders, they can provide valuable resources such as access to public medical aid, referrals, and emergency services.
  • Call treatment centers, write letters, email, don’t give up. It’s hard to find, but some centers do have “free beds” or scholarships for treatment. The Willough at Naples Florida is good for those.
  • Call therapists and ask about sliding scales fees that they may offer.
  • Keep up to date on research trials that are coming up. They need participants and often offer some sort of treatment in return. A list of currently enrolling treatment studies can be found on our Treatment and Research Studies page.

 

Other Helpful Links

Rx Connect- Medicare Prescription Drug Coverage

RX Assist: Provides qualified low-income individuals and families with access to generic versions of brand name medications

RX Hope: Apply for Patient Assistance

RX Hope: Patient Assistance Information Search

Kantor & Kantor Law Firm Lisa Kantor has extensive experience in fighting for insurance coverage for people with eating disorders.

Minnesota Comprehensive Health Association Provides health insurance for those who have been turned down from other health insurance programs due to a pre-existing condition.

US Pre-Existing Condition Plan Provides insurance for those who have been turned down from other health insurance programs due to a pre-existing condition.

NAMI Patient Assistance Program Directory

Government Assistance (US)

Partnership for Prescription Assistance

Portico Healthnet: Connects people with free or low-cost health insurance coverage in the Minneapolis/ St Paul area

Mental Health Parity Law Toolkit (pdf): A thorough discussion of how to appeal insurance company decisions and your rights under the new Mental Health Parity laws.

 

Treatment Scholarships

ED Referral Scholarship

The Eating Disorder Referral and Information Center will to contribute five sessions at a significantly reduced rate, which will be paid for by $250 scholarships. We hope to generate donations which will help provide treatment For an application, send a self-addressed, stamped envelope to:

Eating Disorder Referral and Information Center

2923 Sandy Pointe Suite 6

Del Mar, CA 92014

Be Totally Free

Eating Disorder Foundation of Orange County

Eating Disorder Referral and Information Center

Escape to Reality Foundation

F.R.E.E.D. Foundation

I Am Free Ministries Provides information on multiple Christian-based treatment scholarships

Manna Fund

Mercy Ministries

Milestones in Recovery

Moonshadow’s Spirit

Escape To Reality Foundation

 

Fighting for Better Mental Health Insurance Coverage

How Can I Help?

Alliance for Eating Disorders Awareness

Bazelon Center for Mental Health Law

Eating Disorders Coalition for Research, Policy, and Action

National Eating Disorders Association

 

Why Is Change Necessary?

The following information has been provided by the National Eating Disorders Association:

In the United States, eating disorders are more common than Alzheimer’s disease (five to 10 million people have eating disorders compared to four million with Alzheimer’s disease).

Despite its prevalence, there is inadequate research funding for Eating Disorders. Funding for eating disorders research is approximately 75 percent less than that for Alzheimer’s. In the year 2000, the National Institute of Health (NIH) funded the following disorders accordingly:

  • Eating Disorders (five to 10 million people affected): $14,673,000
  • Alzheimer’s Disease (4.5 million people affected): $59,721,000
  • Schizophrenia 2.2 million (people affected): $234,799,000

Anorexia Nervosa is more expensive to treat than schizophrenia, yet insurance coverage for treatment is exceedingly insufficient. The average direct medical costs for treating Anorexia Nervosa is $6054 a year compared to $4824 a year for Schizophrenia.

Research dollars spent on Eating Disorders averaged $3 per affected individual, compared to $107 per affected individual for schizophrenia.

The average direct medical costs for treating eating disorder patients in the United States is currently between $5-6 Billion per year, whereas the global cost of anti-psychotic medication is $7 billion per year.

Anorexia Nervosa has the highest premature mortality rate of any psychiatric disorder. The majority of deaths are due to physiological complications.

Although recovery from Anorexia Nervosa is often protracted nearly a decade, the outcome of treatment is better than for obesity or breast cancer.

 

 

 

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