The National Eating Disorders Association (NEDA) fields many questions each day that focus on gaining access to care and navigating insurance issues. While there is little argument that early intervention offers the best chance for recovery, insurance often works as a barrier to prompt, thorough treatment. Eating disorders are life-threatening illnesses and anorexia has the highest mortality rate of any mental illness. Yet insurance companies routinely deny coverage for treatment even though studies have shown that a full-course of treatment is cost effective.
To bring you the best possible resources on insurance issues, NEDA partnered with family members and professionals from across the United States who have experience fighting insurance companies to develop strategies for people looking for help. We encourage you to download the following guides to assist in your quest for care. They are also available in our Parent Toolkit.
Navigating and Understanding Insurance Issues
This guidance is intended to assist people looking for help when accessing care and when insurance denies coverage for treatment of eating disorders. The information here was compiled from research by ECRI Institute and the experience of parents and treatment providers who have had experience obtaining coverage for eating disorders care.
COBRA Rights Checklist
This is a list of requirements that employers must follow to inform their group health plan beneficiaries (employees, spouses, dependents) of their rights under the Consolidated Omnibus Budget Reconciliation Act (COBRA). Learn more.
Sample Letters to Use with Insurance Companies
This section provides seven sample letters to use for various circumstances you may encounter that require you to communicate with insurance companies. These letters were developed and used by families who encountered these situations. Learn more.
How to Manage an Appeals Process
Appeals can take weeks or months to complete, and health professionals and facilities that treat eating disorders advise that it’s very important for the patient’s wellbeing to stay in treatment if at all possible to maintain progress in recovery. Learn more.
Securing Eating Disorders Treatment: Ammunition for Arguments with Third Parties
Unfortunately, some patients and families frequently have to fight to get the appropriate and necessary treatment for eating disorders. Here are some arguments to use when trying to secure treatment from an insurance provider or another third party. Learn more.
Navigating our healthcare system can be a difficult maze, especially with mental health issues. But when your loved one's life is on the line, you just want to get them help as fast and effectively as possible. Most insurance policies have a designated appeal process, but the ideal scenario would be to get a "yes" on the first request for treatment authorization. This webinar is designed to put you in the best possible place to get that yes. We will discuss the rights and coverage people should look for in their policies, how to leverage mental health parity laws including the recently released Final Guidelines on federal parity, how to put together complete documentation and the impact of the Affordable Healthcare Act. We will also touch on the appeals process so you can be prepared in case you have go down that road. Dawn Lee-Akers is the Insurance Specialist for Diabulimia Helpline, a non-profit organization dedicated to support, education and advocacy for people struggling with diabetes and eating disorders. Follow along using the downloadable powerpoint slides. Recorded live on July 10, 2014.
If you would like to speak with one of the NEDA Navigators that battled their insurance company for coverage, email email@example.com.