When seeking treatment for an eating disorder, two of the first questions that often arise include “How much will treatment cost?” and “How will I pay for treatment?”
The answers to these seemingly simple questions depend on a great many variables. Eating disorders are complex illnesses that present with a number of psychiatric, medical, and nutritional issues. Treatment needs will vary based on the severity of these various factors. Patients often require coordinated care from several health care professionals.
结果,饮食障碍的治疗通常非常昂贵。鉴于这种现实,美国患有饮食障碍的绝大多数人都没有令人惊讶的是,患有疾病的绝大多数人根本不会得到任何治疗方法。然而,更好地了解选项以及如何为自己或您的家庭成员提供饮食障碍的倡导者可以帮助您获得帮助。
Levels of Treatment
One of the first factors affecting the cost is determiningwhat level of careyou need.
更密集的治疗需要,more expensive it is. For example, being hospitalized in a psychiatric or medical hospital is going to be the most costly; as you progress to less intensive levels of treatment (generally: residential, partial hospitalization, intensive outpatient, outpatient), the cost decreases.
Overnight facility stays are the most expensive. In addition to care from more professionals, the cost includes room and board. Medical centers have even higher costs because of the nursing and medical specialists involved in care.
美国的住院性饮食障碍计划在2015年收取平均每日费用2,295美元;其部分住院计划收取1,567美元。2010年的住宅计划平均每月收取30,000美元的费用。考虑到许多患者可能需要三个或更多个月的治疗。
逗留时间也有很大差异,患者可能需要几天到几个月的不同水平治疗。虽然每个患者的经验都是独一无二的,但在较高水平的治疗费用远远往往导致患者在较高水平的治疗水平和较低水平的时间内支出相对较少的时间。
It is an unfortunate state of affairs in the US that many treatments are cut short by insurers that limit stays in the higher levels of care.
Will Insurance Cover My Treatment?
如果您有幸拥有健康保险,那么您所拥有的下一个问题是保险将涵盖您的待遇。这个问题具有同样复杂的答案。
治疗in medical hospitals or university health centers is usually covered under a patient’s medical health benefits. Typically only short-term stays for medical reasons (unstable heart rate, etc.) are covered.
在住宅中心治疗和所有较低的护理水平通常根据一个人的心理健康效益提供。万博手机客户端第一个住宅饮食障碍治疗计划于1985年开放。在20世纪90年代,由于管理护理开始大幅缩短医院饮食障碍,其他住宅中心很快遵循治疗差距。
Patients with eating disorders are increasingly receiving treatment at this level of care, partly in response to changes in federal law.
The Mental Health Parity and Addiction Equity Act
Signed into federal legislation in 2008, this law requires insurance companies to provide coverage for mental health and substance use disorders that is equivalent to that for physical health problems.
This applies to most larger group health plans. For example, the law requires that insurers do not set behavioral health visit copays higher than medical visit copays at the same level of care. The parity law also impacts treatment limits, mostly eliminating the annual session caps that used to be common among mental health programs.
The Anna Westin Act
Passed by Congress in 2015 as part of the 21st Century Cures Act in December 2016, further clarified that residential treatment for eating disorders was intended to be covered as part of the parity law.
Getting Insurance to Pay for Treatment
您必须熟悉您的保险单或健康福利计划。如果您没有,请求雇主或保险公司的副本。了解您对不同级别的护理的报道。致电您的保险公司并询问是网络中的设施和/或门诊提供商。
In-network providers and facilities are contracted directly with your insurer—they will be the least expensive option. Determine whether you have a large deductible to meet before the insurer starts to contribute to the cost of care and whether after this contribution begins you will have a copay—the portion of the stay or sessions you are expected to pay directly.
You can then call facilities and providers and ask them for your treatment options. If you can find an-in network provider who is contracted with your insurance company, this will always be a cheaper option. However, be aware that many therapists who specialize in eating disorders do not accept insurance. Balancing the competing priorities of provider competence and cost of care can be tricky.
If your outpatient provider will not bill insurance directly, some will provide a superbill which is an itemized invoice that has the information you need to submit to your insurance company in order to seek partial reimbursement for the cost of a session.
If you can’t find a facility or provider who accepts your insurance, you can also request a single-case agreement from your insurer. This allows your insurance company to treat the facility or provider as if they were in-network and pay their fee for your treatment. This is not guaranteed —achieving this can require a lot of advocacy on behalf of yourself or your family member.
You should be prepared to take on your insurer to advocate for you or your loved one’s care. Sometimes insurance companies will refuse to pay for necessary treatment or will prematurely curtail treatment. It is common for insurers to demand discharge once a patient’s weight begins to improve.
他们可能会这样做而不看待完整的临床图像重量恢复当然只有一个短腿的康复之旅。在这种情况下,您的提供商可以代表您提出上诉。
You may even need to register a legal complaint against your insurance company to get them to pay for your treatment. If you or a loved one is struggling to secure treatment for an eating disorder, visitwww.DontDenyMe.org了解您的权利并与资源相关联,以提出上诉并向您的健康计划发出投诉。
Regarding publicly-funded programs throughout the US, there is a shortage of specialized treatment for eating disorders. Medicare and Medicaid providers at all levels of care are often limited. Many plans cover acute medical hospitalization but not lower levels of care. Few outpatient providers accept public insurance.
Getting Treatment Without Health Insurance
Eating disorder treatment is notoriously expensive. For many patients, this is a huge barrier. However, there are other options:
- Community mental health centers: Low-cost counseling centers can provide treatment but may lack providers with specialized training.
- Family-based treatment(FBT): Adolescent eating disorder treatment is sometimes an alternative to more costly residential treatment for teens. In FBT, a lot of the treatment is task-shifted to the parents who are charged with renourishing their teen and interrupting eating disorder behaviors.
- Support groups: These provide support to those who are unable to access treatment. The National Eating Disorder Association has alist of low-cost options including support groups。
- 治疗奖学金: Scholarships are provided directly by some treatment centers. Project Heal is an organization that provides treatment scholarships to various treatment centers around the country.
- University research programs: You may find low-cost treatment in exchange for participation in clinical research. You can reach out to major research universities and inquire about research studies.
- Web-centered: Or app-centered, and workbook-centered self-help and guidedself-help options也可以有所帮助。
Additional Resources
The Alliance for Eating Disorder Awareness has aninteractive treatment finder toolthat includes eating disorder treatment options at all levels of care. You can also search for programs that accept Medicare and Medicaid.
A Word from Verywell
Financial barriers to treatment are real. It’s tough enough to be挣扎着饮食失调and having to worry about affording treatment adds another layer of stress and difficulty to the problem. But doing your research and advocating for yourself or your family member with an eating disorder can help you to get needed help.