Get Adobe Flash player
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 Page  | 46