A few years ago, I received a postcard in the mail from my health insurance company. It said something along the lines about how they "cared about my health" and would "always be there for me."
The offending piece of paper cued a half-hour, f-word laden rant about the hypocrisy of such statements. When I was critically ill with my eating disorder, in an out of the ER several times a week, they refused a higher level of care, saying it was "not medically necessary." Never mind that my own physician, my therapist, and even the doctors in the ER were saying adamantly that if I didn't get treatment, I would die.
I'm not quite sure how these actions come from the same company that supposedly cares about me.
Eventually, my parents and I got sick of the games and raided our collective savings to send me to a treatment program at the cost of $1000 per day. The insurance company refused to even consider a single case agreement or hear an appeal until I was discharged.
I was at the facility for seven months. You do the math.
The problem is that residential treatment—even the best residential treatment—doesn't fix you. I left without a good transition plan or any real clue about how to eat in the real world. The treatment center saved my life, absolutely, but I wasn't well, not by any stretch of the imagination.
It will come as no surprise to those in the eating disorder community that I relapsed shortly after leaving treatment. With a long-term, chronic eating disorder, even seven months was not enough time to get my disorder into remission. I needed supervision and support at every meal for a long time, which was something I didn't have after discharge, and something no one told me I might need. Because I couldn't do recovery on my own, because I felt I had failed treatment again, because I knew that my insurance company wasn't going to pay for further treatment, I felt I had become a burden to my family and society. So I tried to take my own life since I didn't see things getting better.
Obviously, I survived.
The suicide attempt scared my parents and, in retrospect, it scared me. In a sense, it helped spur me on to recovery because it was clear I probably would not survive another relapse. My treatment team insisted I move home where I got the 24/7 support I desperately needed, where everyone could be sure that I ate every meal and every snack every single day. No exceptions. As in residential, I was giving only a limited say over my intake- my treatment team and my mom determined the exact amounts. I worked hard in therapy. Recovery was my full-time job.
It was probably the most difficult thing I had ever done. But for the first time in more than a decade, my weight reached the level where it needed to be. With so much structure and support on the eating front, I could focus my time in therapy on anxiety and depression, rather than by lurching from crisis to crisis.
As an eating disorder blogger, I hear a lot about people's insurance problems. It's the rule, rather than the exception, that an insurance company fails to pay for treatment deemed necessary. These decisions are obviously made with an eye towards the bottom line, rather than the patient's health. It's hard enough to fight an eating disorder, and yet patients and families have to battle both the disorder and the people who you are paying to help provide medical care.
My response to the insurance company's postcard today is the same as it was a few years ago. I ripped the damn thing up and told them to go shove it. I'll believe they care about my health when they stop being a barrier to getting well.
Carrie Arnold is a freelance science writer who blogs on eating disorders at EDBites.com. She lives in Virginia with her cat.