NEDA TOOLKIT for Parents
• Don’t assume one department knows
what the other department is doing. Copy
communications to all the departments,
including health, mental health, enrollment,
and other related departments.
• Don’t panic when and if you receive the first
denial. Typically, a denial is an automatic
computer-generated response that requires
a “human override.” Often you need to go up
at least one level, and perhaps two levels, to
reach the decision maker with authority to
override the automated denial.
• Your insurance company only knows what you
and the treating professionals tell them. Make
sure they have all information necessary to
make decisions that will be of most benefit to
you or your loved one.
• Make no assumptions. Your insurance company
is not the enemy – but may be uninformed
about your case. Treat each person as though
he/she has a tough job to do.
Congress that allows people who have lost insurance
benefits to continue those benefits as long as they
pay the full premium and qualify for the program. See
www.cobrainsurance.com for more information. A
person eligible for COBRA has only 30 days from the
time of loss of benefits to enroll in a COBRA plan. It
is critical that the sign up for COBRA be done or that
option is lost. Be sure to get written confirmation of
COBRA enrollment from the plan. If the student is not
eligible for COBRA, an insurance company may offer a
“conversion” plan for individual coverage.
Obtain a case manager
A case manager will be a single person at your
insurance company who will handle your loved one’s
case. This can make it easier to contact your insurance
company with questions and other issues, since you
will only have to make one phone call. As well, this
individual will become familiar with your loved one’s
case, facilitating decision making.
Be aware that if the patient is a college student who
had to drop out of school to seek treatment and was
covered by school insurance or a parent’s insurance
policy, the student may no longer be covered if not
a full-time student. While many people will continue
working or attending school, some cannot. If this is
the case, it’s important to understand what happens
with insurance. Most insurance policies cover students
as long as they are enrolled in 12 credit hours per
semester and attend classes. Experts in handling
insurance issues for patients with eating disorders
caution that patients who have dropped out of school
should avoid trying to cover up that fact to maintain
benefits, because insurance companies will usually find
out and then expect the patient to repay any benefits
that were paid out.
If coverage has been lost, the student may be eligible to
enroll in a Consolidated Omnibus Budget Reconciliation
Act (COBRA) insurance program. COBRA is an Act of
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