It’s quite a contradiction that those responsible for paying for treatment of eating disorders are the least knowledgeable about the illness. Eating disorders are incredibly complicated and complex illnesses, which may require intense therapy in residential treatment facilities for as little as a month, or as long as several years. Eleven million Americans suffer from eating disorders, and many of these people require inpatient or partial hospital treatment programs. A long running and relentless conflict persists as insurance companies deny treatment for eating disorders, or cut treatment short before the patient has progressed enough to return home.
Although Parity laws require insurance companies to pay for treatment, insurers continue to fight this law in attempt to lower their expenses. Treating eating disorders can be extremely costly, running a bill of about $400 per day for outpatient and $2,500 per day for inpatient.
Insurance companies review the progress of a patient’s treatment, perhaps not fully understanding that this is a life threatening medical disease, frequently arguing a lower level of treatment. Alternatively, the treatment team, which is full of eating disorder professionals and experts, spends a great deal of time working with the patient and recognizes the dangers of treatment being prematurely terminated.
Attention Insurance Companies:
See NEDA for more facts.
If insurance companies were required to take courses on eating disorders, their knowledge would greatly expand, and ideally they would not be content denying people access to treatment essential to their success and survival. In Harlick v. Blue Shield, Lisa Kantor argued for her client’s eight month stay in a residential treatment facility. She argued that although eating disorders are misunderstood, they are curable and should count as essential health benefits. “She likened anorexia and bulimia to cancer, noting it would be unimaginable for an insurance company to refuse to cover cancer treatment.” San Francisco Daily Journal
John Wohlers, the Centre Syracuse Clinical Director understands the duration and complexity of treating eating disorders, and how this often gets lost in translation with insurance companies. “Insurers vary in terms of their sophistication, understanding eating disorders, understanding what treatment entails. There are some insurers that are very sophisticated and then it is much easier to talk with them about what the needs of the patient are.”
Treating an eating disorder takes time, a lot of it. It has deep psychological roots that we cannot begin to address until a patient’s physical condition is restored to a safe place. Once insurers properly understand this, and the severity of the disease, perhaps then we can focus more on recovery and less on fighting for coverage.