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No one with an eating disorder should be denied treatment, just because he or she cannot afford it and does not have insurance. Every effort must be taken to accommodate the client's financial budget, so as to make treatment possible for him or her.
This page brings together helpful resources to consider when developing a plan on how to finance treatment as well as how to work with insurers who deny coverage for eating disorder treatment.
If you have other ideas or resources for others on this subject, please share this information with Chris@NAMEDinc.org for inclusion on this page.
Treatment is costly and the more intense the treatment, the more expensive. Unfortunately, the trade off for feeling better is being financially drained due to medical, counseling, and medication expenses. But, it is important to invest in yourself or your loved one. Your life, health, and happiness are beyond price!
The Eating Disorders Help: A Tool Kit website offers strategies for communicating with your insurance provider, sample letters to write to your insurance company, how to manage an appeal, and reasons insurers give for denials. This website is for patients, their families, clinicians, and attorneys. Visit www.edtreatmenthelp.org
See Section 3: Insurance Issues:
- Navigating and Understanding Insurance Issues
- COBRA Rights Checklist (What is COBRA – see www.cobrainsurance.com/COBRA_FAQ.htm)
- Sample Letters to Use with Insurance Companies
- How to Manage an Appeals Process
- Securing Eating Disorders Treatment: Ammunition for Arguments with Third Parties
Insurance Issues – A 16 page N.E.D.A. document offering recommendations for communicating and working with insurance companies as well as how to handle an appeal and sample letters. Go to
www.nationaleatingdisorders.org/nedaDir/files/documents/handouts/InsuranceIssues.pdf
Insurance Coverage Issues – On Evelyn Tribole, MS, RD’s website at
www.evelyntribole.com/resources/eating-disorders
- Academy of Eating Disorders Position Statement: Eating Disorders are Serious Mental Illnesses - Explains why insurance should cover eating disorder treatment and why they preclude it from coverage.
- Arguments for Insurance Coverage for Eating Disorders Treatment - Article by Margo Maine, PhD giving 10 reasons treating eating disorders is cost-effective.
- Insurance and Paying for Treatment - Information by F.E.A.S.T.
- Effective Tips on Appealing Denial of Insurance Coverage - While this information by E.C.R.I. Institute is directed to those with bulimia, its 8-tips are applicable to any eating disorder.
- When Insurance Denies Coverage - Document by N.E.D.A. on how to work with your insurance company. Includes sample letters to send to insurer.
- Treating Eating Disorders and Paying For It - New York Times article by Lesley Alderman on eating disorders and insurance.
Getting Your Insurer to Pay for Eating Disorder Treatment article on Mirasol Eating Disorder Recovery Center’s website at
www.mirasol.net/treatment-programs/paying-for-treatment/insurance-coverage.php
Eating Disorders and Insurance article by Sara Bradshaw at
www.ezinearticles.com/?Eating-Disorders-and-Insurance&id=5430439
Insurance Companies Label Eating Disorders “Behavioral Illnesses”, Refuse to Cover Mental Health Costs article by Holly Anne Manning, Publications Coordinator, National NOW Times, Winter 2007. Visit www.now.org/nnt/winter-2007/eatingdisorders.html
The Eating Disorders Coalition (EDC) is lobbying to get the federal government to pass legislation requiring insurance companies to cover eating disorder treatment like any other mental illness. Visit www.eatingdisorderscoalition.org
Medicaid is a federally funded medical and health service program operated by each state providing services to people with low income and limited assets who cannot afford treatment. There are additional eligibility criteria and each state’s eligibility criteria varies. To find out more about Medicaid and state offices to contact, visit the Centers for Medicare & Medicaid Services (CMS) at www.cms.gov/home/medicaid.asp and www.cms.gov/MedicaidEligibility
Medicare is a federal health insurance program that helps pay for hospital and medical expenses for Americans 65 and older and certain disabled groups. For more information on Medicare, go to www.ssa.gov/pubs/10043.html and www.medicare.gov
If you are confused by the difference between Medicaid and Medicare, see the chart showing the differences between Medicare and Medicaid at www.medicaidhelp.com/difference.htm
For individuals with no insurance and limited income, consider treatment from mental health centers and community agencies (such as family service centers and hospitals with clinics) and low fee clinics offered by the Psychiatry Departments of Medical Schools.
To find low income clinics near you, go to www.freemedicalcamps.com or try to find low income clinics in your area by doing an internet search on “low income health clinics and …” the name of a large city near you. Or try finding low income clinics listed in the phone book.
Large metropolitan areas may have a helpline to call for referrals to low fee clinics. For example, in Los Angeles, CA the Department of Mental Health Access Center has a 24/7 helpline at 800-854-7771 where callers can get referrals to low cost medical care in the Los Angeles area.
While treatment by a multi-disciplinary treatment team of eating disorder specialists is ideal, these low cost alternatives are better than no treatment at all.
How Will I Pay - See Something Fishy Website on Eating Disorders at www.something-fishy.org/reach/howwillipay.php
Paying for Treatment on The Elisa Project website at
If you cannot pay at point of service, discuss a payment plan with the billing department or counselor.
Get treatment from counselors and facilities that accept a sliding scale fee. A sliding scale fee for a counseling appointment refers to offering a client with no insurance and a low income a discount session rate, in order to make treatment possible for him or her.
Students paying a Student Health Fee can obtain free counseling at their College Counseling Center or Student Health Services.
Research study programs may pay for all or part of a participant’s treatment in exchange for his or her participation in the study. Participants in research studies may be monitored for years and be required to periodically complete questionnaires, undergo interviews, and follow a certain treatment plan that researchers will assess the effectiveness.
One such study for eating disorders is being done by the University of Chicago Eating Disorders Program. For details, see the Treatment Provider Directory on this website under “Illinois” and “Free Support Groups & Research Studies”.
Here are a few organizations that offer scholarships or grants for eating disorder treatment:
The Gail R. Schoenbach F.R.E.E.D. Foundation at www.freedfoundation.org
Manna Scholarship Fund at www.mannafund.org
The Jennifer Mathiason Fund at www.moonshadowsspirit.org
The Kirsten Haglund Foundation at www.kirstenhaglund.org
National Eating Disorder Referral & Information Center at
www.edreferral.com/scholarship_foundation.htm
Eating Disorder Recovery Support, Inc. (EDRS) at www.edrs.net
If you need help paying for your prescriptions, contact customer service at the pharmaceutical your medication is manufactured to inquire about whether your medication is covered by their Patient Assistance Program, and if so, what are the eligibility criteria for getting free prescriptions.
You can also go to the RxAssist website at www.RxAssist.org to find out if your medication is covered under a Patient Assistance Program, and if so, what are the criteria for receiving free medication.
Also, visit www.complaintsboard.com/articles/do-you-need-help-paying-for-your-prescription-medication.html for recommendations on getting help paying for your prescriptions. The site does not provide links, so you need to do an internet search on the programs to get more information.
Another option is to find out if your area participates in the Coast2Coast Rx (Prescription) Program. This program provides a Free Prescription Discount Card that can be used at participating pharmacies. You must live in an area that sponsors the program. There are no eligibility restrictions. The entire family can use the same card. You save a certain percentage off your prescriptions. Percentages off the price vary according to the medication. Visit www.Coast2CoastRx.com for more information and to print your discount card.
Consult your local Health Department for prescription discount programs and for referrals to low cost treatment in your area. Also, inquire about what services are available to you through your local Health Department.
Additionally, find out if your doctor who prescribes your medication can give you samples.
A human life is beyond price. Value life and strive for a quality existence. Recovery brings happiness, peace, and energy back to life. Relationships are improved and become more satisfying. There is renewed interest in partaking in life. Be willing to spend money for treatment for yourself or your loved one. There is such an exuberance to having one’s life back and a renewed spirit!
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INSURANCE & PAYING FOR TREATMENT
