Insurance Coverage for Bulimia Nervosa 

Still, treatment for these conditions can be lengthy, and many programs are expensive to boot. As such, most people rely on health insurance coverage to access the comprehensive care they need.

So if you’re wondering, “Does insurance cover eating disorder treatment?” you’re not alone. But the answer is often complicated and will vary on a number of factors.

Does Insurance Cover Bulimia Nervosa Recovery?

The short answer is yes; many health insurance policies will cover treatment for most common eating disorders, including bulimia nervosa. But each policy may cover different types of treatment programs or offer different amounts of coverage for different periods of time.

Generally, treatment centers for eating disorders are covered by a policy’s behavioral health coverage, and information that pertains to eating disorder treatment is usually found among a policy’s mental health benefits.

To find the specifics on what your plan will and will not cover, you can read your policy or contact a representative from your insurance company directly.

Common Types of Therapy Covered by Insurance

Many insurance companies will only cover certain types of therapy or treatment for bulimia nervosa. Most often, these treatments must be considered evidence-based and deemed “medically necessary” to help someone.

Insurance companies do this for a number of reasons, but the practice helps discourage people from seeking out more experimental or unproven methods for treating bulimia nervosa.

On the other hand, it tends to direct people toward a number of commonly-covered treatments, including: [2]

• Cognitive behavioral therapy (CBT)
• Exposure therapy
• Family therapy
• Psychiatric emergency care
• Medication
• Nutritional counseling

Many of these programs are administered on an outpatient treatment basis. That means patients live at home while commuting to treatment programs several times a week. Sometimes, insurance coverage for eating disorders requires patients to try outpatient care options before moving on to other types of eating disorder treatment.

Insurance Coverage and Inpatient Treatment

Inpatient treatment for bulimia nervosa is more intensive than outpatient care. These programs, which require a patient to live on premises and give them 24/7 access to care, can take weeks or even months to complete and cost many thousands of dollars.

This incentivizes insurance companies to resist covering the full cost of inpatient treatment. And while many plans theoretically cover this type of treatment, it’s been noted that many people struggle to get full coverage. [1]

Eating disorder treatment facilities are often well-versed in insurance issues. They can assist you in navigating these complex issues to help ensure you receive maximum coverage for your inpatient stay.

Common Reasons for Denial of Coverage

Insurance benefits can be denied for a number of reasons, not all of which are necessarily your fault. An insurance company may not cover a claim due to: [3]

• Clerical errors on the part of the insurance company or the care provider
• The belief that a treatment isn’t “medically necessary”
• Claims that a treatment has no meaningful benefit
• The existence of a less expensive treatment that is considered equally effective

Another common reason for denied coverage is choosing a care provider that isn’t in-network. Most insurance plans only provide coverage for care received from a doctor or facility in the network of providers the insurance company has previously negotiated with. 

Out-of-network care may still be covered, but it will typically be covered at a significantly lower rate, requiring you to pay more out of pocket. Some plans don’t offer any coverage for out-of-network providers, so it’s important to confirm these details before you begin treatment.

Disputing Coverage Denial

Because so many reasons for coverage denial are subjective, it’s important to dispute situations where coverage was denied for care that should have otherwise been covered under your plan.

To successfully dispute a claim, you may need to work with your treatment provider in order to offer the insurance company proof that your treatment was beneficial and necessary. If your coverage continues to be denied, you may need to adjust your treatment plan. This can help you stake a stronger claim for certain types of treatment.

Other options are lodging a formal complaint against your insurance provider, switching insurance providers, or even taking legal action, depending on how damaging the denial of your claims may be.

The process for disputing claims and filing complaints differs from company to company. You may also want to consult a lawyer who specializes in healthcare disputes for further advice on how to proceed.

How to Get Coverage for Bulimia Nervosa Treatment

In order to apply for insurance coverage for eating disorder treatment, you will need an official BN diagnosis from a licensed medical professional. Your insurance company may only accept this diagnosis from in-network doctors, so be sure to read your policy carefully before making an appointment.

Generally, once you’ve obtained an official diagnosis, you can begin receiving coverage for treatments deemed medically necessary. An official diagnosis will also open the door to claiming coverage at different eating disorder treatment programs.

It is generally helpful to confirm ahead of time with both your insurance company and your treatment provider that a given treatment is likely to be covered. If you can ensure that your plan should cover a particular type of treatment, this will make it less likely that coverage will be denied and more likely that you can successfully dispute any issues if a problem does occur.

Finding a Treatment Provider That Accepts Your Insurance

Finding an in-network provider, or one that otherwise accepts your health insurance, is an important step toward getting the fastest, most effective insurance coverage for eating disorder treatment.

Most major insurance providers have tools available that help you look at care providers within their network. Care providers are also generally knowledgeable in the types of insurance they can accept, although they won’t generally know all the specifics of your insurance plan. 

If you’re unsure how to look for treatment providers that can accept your insurance, you can generally get that information by calling or otherwise contacting your insurance company. It may take multiple calls, depending on the specific situation and the information the companies you’re calling need. But it’s worth the extra effort on your part to ensure you avoid any financial surprises down the road.

Securing treatment coverage for eating disorders may be a difficult and frustrating process, but it’s an exceptionally important one, helping to ensure you have all the help you need to find the road to recovery.