“Anorexia has the highest mortality rate of any psychiatric illness,” cites Jillian Croll, Ph.D., speaking at the Insight Behavioral Health Conference in Chicago September 24. “It is the third most common chronic illness among adolescents. More people in the United States are affected by eating disorders than are HIV positive.”
Those are chilling statistics, particularly to those who understand that eating disorders can be successfully treated, but many insurance carriers are reluctant to cover the residential treatment necessary for a full recovery – even though federal law requires that insurers provide the same treatment levels for mental illness as they do for physical illness. And some states such as California have even more stringent metal health parity laws.
So why is it so difficult to get insurance benefits for eating disorder treatment? Croll, who is Director, Education, Research and Program Development for the Minnesota-based Emily Program treatment facilities, points to the fact that treatment takes time, can cost up to $2000 a day, and requires skilled clinical support to diagnose, treat and support full recovery.
Most health plans do not have the facilities and professionals necessary within their networks, so patients must go outside the plan to get successful treatment. Insurers typically attempt to force policyholders to use what’s available within the plan before approving out-of-plan treatment. This is usually a waste of time and can be life-threatening for some policyholders.
As a result, most people have to sue their insurer to receive the level of care they need in a timely manner. We file lawsuits around the country on behalf of people with eating disorders, and have appealed cases to higher courts. Our biggest dilemma is that some women may not have the time it takes to wage a lawsuit for treatment. Having legal counsel with experience filing eating disorder claims is critical when the goal is to have insurance companies capitulate and pay for treatment.