Blue Cross Blue Shield Bulimia Coverage 

But if you have Blue Cross Blue Shield (BCBS), you’re in luck. The provider will usually cover eating disorder treatment, including both residential and outpatient treatment, as long as you have an official diagnosis from a medical professional. 

Still, as with nearly all insurance plans, there are a number of nuances and caveats, and the specifics of what will be covered for you depend entirely on your individual policy with Blue Cross Blue Shield.

Does Blue Cross Blue Shield Cover Eating Disorder Treatment?

In a word: Yes.

Blue Cross Blue Shield plans cover treatments for BN and other common eating disorders, as well as most diagnostic procedures which are used to officially test for these conditions. [1] Generally, the company will only cover treatments or other tests that are consistent with available medical evidence, or considered evidence-based.

Once you have an official eating disorder diagnosis from a medical professional, you should be able to have your care covered through the company’s behavioral health services. 

Still, the exact level of coverage will vary significantly, depending on your plan. Before you begin any treatment, you should confirm your precise level of coverage as well as the maximum you can expect to pay out of pocket, including any deductibles and copays.

What Will Blue Cross Blue Shield Cover for Bulimia?

The Blue Cross Blue Shield family of companies will generally cover treatment for eating disorders that is considered both necessary to help and evidence-based, or proven effective through a series of scientific tests and analyses.

If emergency treatment is needed to help with a crisis related to you or your loved one’s eating disorder, this will be covered at the same level as any emergency services under your plan.

Inpatient Treatment Coverage

Inpatient or residential care for BN may also be covered by your policy when deemed appropriate, although there is a high burden of proof for the necessity of this type of treatment. [2]

Talking to your supervising physician as well as any employees at residential treatment centers you may be looking at may help you build your case. You may need these people to help show that your behavioral health needs are serious enough for long-term, live-in treatment, or you may need to show the insurance company that you’ve already unsuccessfully tried outpatient treatment in order to have these programs approved for coverage.

What Will Blue Cross Blue Shield Not Cover for Eating Disorder Treatment?

As is typical for insurance companies, the Blue Cross Blue Shield family of companies will not cover treatments it deems unnecessary or unproven. 

If there is a cheaper alternative to the treatment you want, which arguably produces a comparable result, your desired treatment may also not be covered—though the cheaper alternative may be approved.

By and large, for a treatment to get covered, it generally needs to be demonstrable that it is medically necessary or at least highly beneficial for a patient’s recovery. But the specifics depend entirely on your individual insurance plan.

How to Start the Treatment Process Using Blue Cross Blue Shield Coverage

To get started with the treatment process, you will first want to get diagnosed by an in-network physician or mental health professional. While you can get this diagnosis from an out-of-network provider, you will pay substantially more, or run the risk of the insurance company having further issues with the diagnosis. It’s important to check the specifics of your plan before proceeding.

Once you’ve been issued an official diagnosis, you can start searching for a treatment provider. Ideally, you’ll start your search with in-network providers and programs. These are more likely to be covered by BCBS, as the companies will have a pre-existing history and previously negotiated price points.

After narrowing down your treatment choices, you should reach out to the residential treatment center you’re considering, whether or not they’re in network, in order to further assure that they can and will work with BCBS and your particular policy. It may seem like an extra step, but it could save you a lot of time, frustration, and heartache down the road, should you enroll in a program that’s not covered and decide to transfer mid-treatment.

Once the i’s are dotted and t’s crossed, you should be able to start your treatment. The care facility will work directly with the insurance company for billing, and you’ll only be responsible for co-pays or any other payments stipulated in your insurance policy.

Finding Treatment Centers in Blue Cross Blue Shield’s Network

The Blue Cross Blue Shield network is fairly large, which can be equal-parts helpful and overwhelming. Luckily, the company has a helpful tool to help customers find in-network treatment providers for all manner of needs. [3]

To use it, enter your location and current plan information, and the tool will show you which in-network providers are most relevant to your query. At that point, you can contact the provider during their business hours to begin scheduling your treatment, assuming you already have a diagnosis and, ideally, a treatment referral. 

It may seem cumbersome to think of so many logistics related to insurance while trying to navigate an emotionally-taxing eating disorder, but taking early steps to ensure treatment is covered can help prevent stress in the future, and help you more quickly get on the road to recovery.