Monthly Archives: March 2011

Eating Disorders and Health Insurance.

A post or so ago, a friend commented that there “was a lot of help for eating disorders” today. 

Well, sure, if you can pay $40,000 for a residential stay or pay $80 for an intake for an outpatient group.  And if you can’t, then you have to jump through the loops of modern health insurance – the kind that denied a recent client of mine weekly outpatient therapy, despite having a triple diagnosis of Eating Disorder Not Otherwise Specified, Alcohol Dependence, and Major Depressive Disorder, INCLUDING suicidal ideation.

Eating disorders aside, the state of our country’s health insurance is appalling and disgusting.  For some reason, our country has a problem admitting when they are wrong (maybe, just maybe, those dangit-crazy Europeans have got it right!).  For those of you who are satisfied with the way it is, let me explain what insurance reviews are.

Insurance reviews are something mental health providers do regularly.  Insurance reviews grant the client more sessions, barring that they are “sick enough” to require it, but – oh oh oh!  Not too sick that your recommendation of merely outpatient therapy is inappropriate.  In these reviews, the mental health provider, who sees their client on a weekly basis, is often berated and told by a Mass Health representative that has NO clinical training that their clinical judgment is wrong.  You know.  Because therapists are so wishy-washy and all.

I once had an insurance reviewer tell me that a man three weeks out of detox did not require once a week counseling, that he could step down to bi-weekly counseling.  Right.

People often tell me I am too serious, too angry, too WHATEVER about this stuff – but this is the very reason I get angry about it – because today, it is normal for disempowered individuals to be denied the coverage they deserve.  And that is wrong. 

So before all this bullshit “Why can’t Obama save the world even though I’m too scared to vote for healthcare reform!” happened, eating disorders were not recognized as a mental illness for long after others were.  The Federal Mental Health Parity Act was signed in 1996; eating disorders were finally recognized under this act in 2005.  (How victorious it was to receive a letter telling me that.)  And because I went into treatment before this was signed, I ended up footing $1000 worth of three weeks of partial-hospital treatment.  I am lucky I had the resources to pay this; most of the people I’ve seen so far don’t.

Even after the Federal change in 2005, there were separate state parity laws.  Most of these deemed that “biologically-based illnesses”, such as schizophrenia or bipolar disorder, were coverable, but that eating disorders were not; they were very quietly left out of the equation.  In Massachusetts, one of the most progressive states in the union, eating disorders were not signed into the Parity law until July 1, 2009.

So yes, Virginia, there is a lot of treatment for eating disorders.  If you’re sick enough.  But not too sick.  And rich enough.  But not too…no, just rich enough.