Denied

In the past decade I have been in and out of several different treatment programs for my eating disorder. I have met so many women and men in treatment, support groups, and online communities. And so many times I have seen someone who desperately needed treatment be sent home because insurance refused to cover it. I know of families who have taken out second mortgages on their house and lost nearly everything in order to pay for their loved one to get the help they needed. I know my parents have spent a ridiculous amount of money paying for my treatment. I was blessed that they could cover the expenses for my treatment. I know a lot of other people who don't have that opportunity. One of my good friends I was in treatment with in the past has recently started to relapse. I encouraged her to try and start a PHP or IOP now to take control before the eating disorder starts to control her again. (PHP is partial hospitalization program, it is a day program where you treated on an outpatient basis but are there for most of the day. IOP is an intensive outpatient program, it ranges from 3-4 hours a night five days a week to 1-2 hours a couple nights of the week.) When I mentioned started a program like that to my friend I found out that there are only two different places near her that offer them and neither will accept her insurance. The cheaper program is $500 a day if she was to pay out of pocket. 

When you hear numbers like that it is hard not to get defeated. In a study done by South Carolina Department of Mental Health they found that only one in ten people with an eating disorder will receive treatment. In the people who do have access to care for their eating disorders about 80% do not get the intensity of treatment that they need for recovery and are often sent home weeks before the recommended stay. Treatment of an eating disorder in the United States ranges from $500-$2,000 per day. The average cost for a month of inpatient treatment is $30,000. It is estimated that individuals with eating disorders need between 3-6 months of inpatient care. The cost of outpatient treatment, including therapy and medical monitoring can extend to $100,000 or more. 

When you use insurance to pay for treatment you will assigned a case manager. This is someone from the insurance company that will talk with your treatment team and essentially decide if you will be allowed to stay in treatment or not. The case manager is wanting to spend as little money as possible which is how so many people show up to treatment just to get shoved right back out the door.

As someone who has been in treatment several times, actually getting to the point where you recognize you need to get help and then making yourself go in takes a tremendous amount of courage. Eating disorders like to tell you don't need help, you shouldn't bother people with things, this 'that' bad. A lot of people, myself included, felt that they didn't deserve to get help. So when you muster up the courage to finally ask for help and your insurance case manager decides that treatment isn't a medical necessity and denies coverage. Hearing that makes you feel like you should not have tried to get help in the first place. 

There is a huge problem with being dropped down to lower levels of care to early. Eating disorders are tricky. They require a lot of intensive work if you are going to be able to keep yourself in recovery after leaving treatment. In treatment you start to gain confidence that you can do it, but the second you walk out of those doors the eating disorder is trying push it's way back in. Which is why step down programs are crucial to recovery. When someone is denied coverage and has to stop treatment she/he is more likely to relapse than someone else who was able to complete the program at the recommended pace for that particular individual. 

I know that eating disorders are not alone in being denied coverage. Anyone seeking help help for mental health issues runs into the same problem. They desperately need the help yet they are constantly turned away. People are dying because of this. Because insurance companies refuse to give people the proper level of care. This needs to change. I refuse to stand back in silence when I see so many people reaching out for help and getting nothing in return. 

Here is a link to the Just Eat Documentary trailer which talks about the dangers of having an eating disorder and how insurance companies deny coverage for the cost of treatment necessary.  I wanted to just embed the video for everyone but I am having difficulties doing that. Please click on the link and go watch the trailer it is fabulous!  

And if you have a little more extra time watch 60 Minutes: Denied it is actually only fifteen minutes. 

But if you don't have time for that here's this: