Keenan: Mental illness needs proper insurance coverage
November 12, 2015
Up to 30 million people of all ages and genders suffer from an eating disorder in the United States, which is a lot more than I expected. I was also surprised to learn that eating disorders have the highest mortality rate of any mental illness.
The most shocking information I found though, was that only 1 in 10 individuals with eating disorders receive treatment. This number can be due to depression, fear or anxiety from the idea of talking to someone about their disease and lack of easily-accessible treatment.
That last reason about treatment is what gets to me the most, however. That’s what I’m most interested in seeing changed because if that changes, we can also change other statistics. I want to know why insurance companies don’t cover eating disorder treatment — I mean truly cover it. They should, eating disorder treatment is just as much of a disease as anything else.
This is a personal subject for me because of my own eating disorder, and I felt incredibly inclined to write this article after recently looking into treatments for myself. I visited doctors, called counselors and dietitians to find answers and I started actually understanding what’s going on with my insurance when it comes to this issue.
Mental illnesses that are “biologically-based,” including brain diseases such as schizophrenia and obsessive-compulsive disorder, are covered. However, eating disorders are not considered ‘biological’ by insurance companies and fall outside their coverage.
Many people aren’t getting the correct care they desperately need, and this is deadly. The National Association of Anorexia Nervosa and Associated Disorders described how insurance coverage works:
“Often there are low caps,” according to the association. “Many will only cover expenses that are ‘medically necessary’ but will not rule on medical necessity until well after treatment has been initiated. Often upon review it is decided that care for eating disorders is not deemed medically necessary.”
The thing about treating eating disorders is they are incredibly complicated. Eating disorders require many different treatments and specialists in order to fully recover. It requires not only medical care but also mental health care and nutritional services because eating disorders are so complex that the standard of care is different in each individual case.
However, in every case, it’s important to understand that eating disorders are serious mental illnesses.
The Affordable Care Act has taken a step forward in giving younger individuals more opportunities for coverage. Under the reform law, some provisions will improve care for eating disorders by allowing young adults to remain on their parents insurance until age 26. This will forbid insurers from removing lifetime caps on mental health benefits and denying eating disorder coverage because it is a preexisting condition.
Another attempted step was taken by The Eating Disorders Coalition, which tried unsuccessfully to get treatments for eating disorders included in the “essential health benefits” that insurance plans are required to provide. Although this was unsuccessful, the idea still stands, and is in my opinion, a positive one.
It’s time to start really understanding the dangers of eating disorders, especially when a person can’t seek treatment just because their insurance does not see it as enough of a problem, and start insuring the correct care that people with an eating disorder require. This means giving the entire, fully-prescribed treatment that individuals need without making them pay out of their own pockets.