Insurance Issues
Proper eating disorders treatment must address both the psychological and physical aspects of the disorder. Many insurance companies have mental health benefits (also known as behavioral health benefits) under a separate umbrella from their physical health benefits. The passage of mental health parity means that, legally, mental health must be covered on par with physical health. However, the separation can still exist, and behavioral health coverage may even be contracted out to a separate company under the supervision of the insurer. This creates a confusing patchwork array of coverage and rules that can make obtaining proper care difficult.
Project HEAL is a national nonprofit that is focused on creating equitable access to eating disorder treatment. They provide information about navigating insurance issues that may help you throughout this process.
Cover My Mental Health provides no-cost resources to individuals, families, and clinicians facing insurance barriers to mental health care, such as “no in-network clinician,” “denied as not medically necessary,” and opaque insurer processes. Downloadable template letters, videos, and actionable guidance is available… so you don’t have to take “no” for an answer. Check out their resources for overcoming obstacles to eating disorder care.
The page below includes a list of sample letters that can be used in various circumstances you may encounter that require you to communicate with insurance companies. They originate from real-world experiences of numerous families and were developed and used by individuals facing similar situations.