Insurance Coverage for Anorexia Treatment

Content Overview

How to pay for Anorexia Treatment?

Anorexia treatment can be expensive. For example, outpatient care can cost more than $100,000. Inpatient treatment can cost much more. Most insurance plans cover medical treatments, including nutritional support, and plans may also cover counseling services. But the coverage limits can vary dramatically from one plan to another. It is best to call the insurance company directly to find out more.

Mental illness impacts the lives of 42.5 million people in the United States every year, per the Substance Abuse and Mental Health Services Administration.
 
There are certain mental health disorders that are more common in individuals who abuse drugs or alcohol, and eating disorders fit into that category.

What Is Anorexia?

Part Of Woman Body Suffering Anorexia NervosaAnorexia is a disorder that affects the body and a person’s overall health by distorting one’s sense of self-image. It inflicts sufferers with a compulsive desire to lose weight and, often, a total aversion to food, as well.

According to the American Psychological Association, around 8 million Americans suffer from eating disorders like anorexia. It affects people from all walks of life, but it is more common in women. The Office of Women’s Health notes 85-95 percent of all people battling anorexia are female. In addition, the disorder affects a large proportion of teenagers and young adults. Over 500,000 teenagers in the United States suffer from an eating disorder, per NBC News.

Red flags that signal the possibility of anorexia include:

  • Emaciation
  • Overwhelming fear of weight gain
  • Menstrual irregularities or absence
  • Hair loss
  • Excessive exercising
  • Persistent dieting
  • Caloric intake restriction or total refusal to eat anything
Treating anorexia is an ongoing process, and it can take several years for individuals to really feel stable in their recovery. Getting help is essential for both short-term and long-term health. Without treatment, anorexia only worsens.


The National Alliance on Mental Illness reports as many as 20 percent of individuals suffering with the disorder will die prematurely as a consequence of it.


The Eating Disorders Coalition reports outpatient treatment for anorexia can cost more than $100,000. Most insurance plans cover counseling services, such as individual and family therapy, which are crucial to overcoming the disorder. Treatment for anorexia also often warrants the need for weight gain programs in which clients have supervised diets that will help them to put on weight. Caloric intake is monitored, as is behavior to make sure individuals don’t try to hide, throw away, or purge food.

When Addiction Contributes to Anorexia

According to SAMHSA, 14 percent of women with substance use disorders also have anorexia. Many who live with anorexia will attempt to control their hunger pangs with appetite suppressants, some of which are addictive.
Often, these individuals resort to stimulants as a way of dampening their appetite and speeding up their heart rate and metabolism. Popular drugs of abuse include cocaine and prescription drugs like Adderall, Concerta, and Ritalin. As many as 11 percent of people who take Adderall lose weight, and about 36 percent of users report a reduction in appetite.

Insurance Coverage for Treatment

While a chosen treatment center can provide guidance on coverage and costs an individual may be responsible for, one’s insurance company is the best resource for this information. Important questions to ask include:

  • Is medical detox for substance abuse a covered benefit?
  • Will coverage be applied for both inpatient and outpatient forms of care?
  • Is nutritional counseling covered?
  • For what duration is treatment covered, and how many trips to rehab are covered during a policy year?
  • Is there a copay for services or medications?
  • What is the policy’s deductible?

Traditionally, medical detox is carried out in a supervised manner in which clients are weaned off the substances they have been abusing, often with withdrawal symptoms treated with medication. There are no medications approved for the treatment of anorexia; however, medications may be prescribed to treat other mental health issues that contribute to anorexia or hinder treatment, such as benzodiazepines to treat the anxiety that many individuals experience related to eating.

Anorexia often warrants the need for inpatient or partially hospitalized care so treatment professionals can make sure the client is eating a balanced diet, or eating at all. Across the country, 835 facilities are available to treat clients with co-occurring mental health and substance abuse issues through partial hospitalization, per SAMHSA. Many of these facilities specialize in the treatment of eating disorders.

Some insurance companies only make payments toward outpatient care when substance abuse is the primary issue cited for treatment.


It’s important to clarify the need for tandem treatment of both anorexia and substance abuse or addiction to insurance companies and rehab clinics.


Special dietary needs must be considered with clients suffering from anorexia. Nutritional counseling is usually a mandatory part of most treatment programs for people with eating disorders. Since addiction and anorexia are both chronic conditions that may require subsequent trips to rehabilitation to treat cases of relapse, individuals should check with their insurance providers regarding time and frequency of treatment limitations. Be clear on any copayments and deductibles that are due prior to payments being made by the insurance company.
For the 71.1 million people who are covered by Medicaid and CHIP (Children’s Health Insurance Program) in the United States — per Medicaid— treatment for both anorexia and substance abuse are generally both covered. If one doesn’t have sufficient insurance coverage, many facilities offer sliding scale payment options and payment assistance programs. In addition, several states offer grants to help fund treatment services for people with financial hardships.

Disclaimer: AAC facilities do not treat anorexia.

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