Let’s Talk About Insurance and Eating Disorders

Why is it so important that EDRS works to get its eating disorder services covered by insurance?

If you’ve ever stopped yourself from seeking help for your mental health because you feared you couldn’t afford it – you wouldn’t be alone. Mental illness has a notorious history of stigmatization and being pushed to the back burner of many insurance companies’ considerations. However, in recent years there has been a larger push to expand coverage for mental health services and make it easier for people to access necessary care. This has taken form in The Mental Health Parity and Addiction Equity Act as well as elements of The Affordable Care Act

In Graison Dangor’s article “‘Mental Health Parity’ Is Still An Elusive Goal In U.S. Insurance Coverage” (written for NPR in 2019), Dangor tells the frustrating story of Amanda Bacon, a woman suffering from Anorexia Nervosa. The article explains that Bacon was not considered ill enough by her insurance company to receive covered treatment. This fact is especially haunting when it is revealed that she had only been consuming around 100 calories a day and had lost 60% of her body weight. Bacon’s story ends well – she was able to switch insurance companies and receive covered treatment; however, it was no easy task. Dangor’s article highlights the ways insurance companies employ various standards for gauging medical necessity. For people who struggle with eating disorders, this can typically mean that they won’t meet coverage standards until they are in an incredibly unhealthy and dangerous situation – most requiring inpatient care. 

While Bacon’s experience is jarring and extreme – it also points to the areas of coverage that EDRS recognized as vital a long time ago and has been working to make accessible ever since. We want to be able to provide continual support as someone transitions back into their world after intensive care – or even get ahead of their condition before any severe action is required. We believe that to achieve full recovery from an eating disorder, it is necessary to not only address the food and eating disorder behaviors but the whole person. Our phase-based approach focuses on the following: stabilization, maintaining factors, and life integration. 

We want to remind our community that access to top-tier clinical care is essential to our mission, and we are proud to work with various insurance companies to make our services as accessible as possible.

We are currently contracted with Anthem BCBS of GA, VA, CT, NY, and OH, Empire BCBS, HealthFirst Medicaid NY, Florida Blue, and New Directions Behavioral Health, and work with other BCBS plans depending on your needs. 

We can verify out-of-network benefits for Cigna and Aetna to see about submitting on your behalf directly to your insurance. At times we can offer a single case agreement working with Cigna.

We are in the process of adding additional insurance contracts in several other states soon! 

We also have private pay options if we don’t work with your insurance. Our experienced admissions team will do their best to create a plan that is financially feasible for you. What is most important is that you have access to the care you deserve. Our FAQ page also has further information on our program and services.  

If you have any questions about your insurance coverage, please email us: info@edrs.com


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