Below are a few examples of denials that our clients have received from their insurance company. These clients (and countless others) have all been adversely affected by an insurance company’s misunderstanding of what it means to be treated for, and recover from an eating disorder, an insurance company’s misdirected and harmful attention to weight, and […]
Category Archives: Residential Treatment
Q & A with Lisa Kantor: How to Get Coverage for the Treatment of My Eating Disorder
Do you have questions? We have answers. This month we decided to do something a little bit different for our newsletter. We reached out to the eating disorder community to find out the type of questions they have when seeking insurance coverage for the treatment of eating disorders. We know that this can be an […]
Guest Blogger Carrie Arnold Doesn’t Believe Her Insurance Company Cares About Her
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 […]
U.S. Supreme Court Denied Blue Shield’s Petition for Writ of Certiorari
On March 4, 2013, the United States Supreme Court brought Jeanene Harlick’s nearly eight-year struggle to a successful end. Ms. Harlick sought to obtain benefits for residential treatment for her eating disorder from Blue Shield of California, her health insurance company. After the Ninth Circuit Court of Appeals ruled in her favor, Blue Shield of […]
Surviving an Eating Disorder: An Inside Look at Recovery
In honor of National Eating Disorders Awareness Week (February 24-March 2), I would like to share with you a very personal, authentic, and profound glimpse into what it means to have an eating disorder. In place of providing you with basic eating disorder information and statistics, I instead leave you with this story of a […]
When Insurance Companies Hinder Eating Disorder Recovery
I recently joined in on a webinar entitled, “Insurance Companies are Not the Enemy.” I was intrigued by both the title in combination with the fact that the National Eating Disorders Association (NEDA) was presenting this webinar. I admit that I was hopeful that I would learn new information in the webinar, and that I […]
It’s 2013…But Eating Disorder Patients Continue to Fight For Coverage
Securing insurance benefits for the treatment of an eating disorder can be an extensive battle. This battle often comes in the form of repeated denials, being told you can “be safely treated at a lower level of care,” appeals, and even being quoted incorrect benefit information. Those who suffer from eating disorders, and their families, […]
BMI: The Insurance Companies’ Death Knell to Adequate Treatment for Eating Disorders
Review any insurance company’s denial letter for eating disorder treatment based on medical necessity, and weight or the insured’s BMI (Body Mass Index), will form the basis of the denial. What is BMI and why do insurance companies refer to it as if it was the Holy Grail for determining the “healthy” weight of its […]
Why You Need to Know Your Policy
Save Those Envelopes!Our client is covered by an employer sponsored group plan based in New York. The Plan denied our client’s residential treatment for her anorexia based upon medical necessity. We submitted a timely appeal. On April 23, 2012, we received the Plan’s response denying the appeal based upon medical necessity. The appeal denial is […]
Parity and Disparity Coast to Coast: A Case Study
Merriam-Webster defines par◦i◦ty as, “the quality or state of being equal or equivalent.” Derived from the Latin word for equal, paritas, its origin dates back to 1608. Such lineage, however, has done little to integrate the concept of parity into the vocabulary and mind set of the health insurance industry when it comes to approving […]
