International Federation of Eating Disorder Dietitians
    International Federation of Eating Disorder Dietitians

Have you or a family member experienced Eating Disorder Discrimination? Share your story at the bottom of the page.

Eating Disorder Discrimination involves refusal by insurance companies to pay for the costs of eating disorder treatment, including but not limited to  hospitalization; residential, partial hospitalization or day treatment care;  nutrition counseling; psychotherapy; doctor visits; testing or procedures;  medications; psychiatrist visits; group therapy; other recommended treatment. 



Eating Disorder Discrimination also involves delays in approving or paying for  eating disorders treatment; refusing to pay for a full course of treatment and  terminating coverage before a patient is safe to leave treatment; insurance  company harassment of patients or their families, refusal to answer questions  relating to coverage, and denying treatment after it was previously approved.

 

The reasons behind Eating Disorders Discrimination are numerous, but multiple successful lawsuits around the country and unfortunately, many deaths and the ongoing deterioration of patients waiting for treatment, show that it cannot continue.

The most obvious problem is exclusionary criteria which specifically state  that eating disorder treatment will not be covered. Some states have mental  health "parity" laws, which do not allow some mental illness to be excluded, but in other cases, illnesses such as schizophrenia and others are included while eating disorders are still excluded.







The following excerpt from the Eating Disorders Coalition website explains more: 



Currently the options for eating disorders treatment are highly variable based on where a person lives. A state such as Rhode Island with a comprehensive state parity law requires insurance companies to provide eating disorder treatment so that individuals in that state have options for care. Contrast this with states like Wyoming and Arkansas that have no parity law and no eating disorder treatment available within the state, yet based on national prevalence data, these two states alone likely have over 75,000 individuals with eating disorders within their borders. In the absence of a uniform standard, we believe there is a significant risk that eating disorders will continue to be inadequately covered in many States.

 

The degree to which Americans enjoy full access to covered services will depend, to a large degree, on the medical necessity standards that plans use to determine whether a service within these categories is covered. Few regulations address the definition of medical necessity: there is no federal definition, and only about one-third of states have any regulatory standards for medical necessity. Consequently, the definition of “medical necessity” is most commonly found in individual insurance contracts that are defined by the insurer. As a result, the standard of medical necessity is most often controlled by the insurer, not the treating professional. This has dire consequences for people suffering from eating disorders who are continually discharged from treatment or denied treatment based on erroneous and shifting definitions of medical necessity, per insurers.

 

Exclusion of eating disorders is all too common on the part of insurers seeking to limit interventions deemed non-essential. Despite being biologically based mental illnesses with severe physical health complications, including death, eating disorders are all too often found on lists of benefit exclusions.

 

 

Have You Experienced Eating Disorder Discrimination?

Comments

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  • Andrea (Tuesday, April 24 18 02:02 pm EDT)

    I suffered from EDs for 20 yrs. I had been stable for 9 until a dentist destroyed my teeth and jaw stabilization leaving me in much pain and the inability to chew food. Since my past EDs left me with digestive complications and thinning bone in my jaw, the only treatment recommended is a full mouth reconstruction. My health insurance does not deem a functioning mouth for a formerly severe anorexic/bulimic to be of any urgency. Not chewing food has inflamed the physical and mental issues I had previously conquered but I still have been left without solid food for 16 months. Thank God I studied nutrition and have kept weight up through liquid fat means, but I do not think it is appropriate for insurance companies to dictate treatments of any kind for an illness they know nothing about. Provider's ignorance got me into this mess, and now insurance company keeps me in this position because eating food to them is "not medically necessary". It's ridiculous and this has to change. If breast reconstruction, gender reassignment, bariatric surgery and skin removal are all covered as medically necessary...then I do not see how a functioning mouth is not.

  • Jenna (Tuesday, October 13 15 08:54 pm EDT)

    I am a sufferer, but my weight is not "low" enough to warrent anything like a diagnosis of one, i have EDNOS. Its hard getting help from just specialists let alone treatment... which in terms means I
    am not recovered yet.
    Im hoping someday this all changes.

  • Kellie (Monday, February 03 14 02:02 pm EST)

    An eating disorder is not a trend. it is not a phase. Its not fun or glamorous. An eating disorder is a real life, life threatening disorder.

    I honestly feel insurance companies do not get that. I didn't stop eating because i wanted to. And it wasn't as simple as "just eating"
    My insurance company did not cover dietitian therapy for an eating disorder diagnosis, because "it wasnt a medical necessity". They would however, pay if you had a diagnosis of diabetes or renal
    insufficiency.
    It was so frustrating trying to get my insurance company to cover treatment for my eating disorder. Everything we tried came back as "not a covered benefit"
    I lost all hope in any chance at recovering, because i knew i couldn't do it myself.
    I have since changed insurance companies. But pay more for few added benefits. I still don't have coverage for proper treatment benefits.
    Even after finding a place that can use my inpatient benefits, its still a huge chunk of money out of pocket.
    I can finally see a dietitian (after 8 years of struggling with ed)and i feel she has helped so much!
    I know that with better coverage for more intensive treatment, ill be able to have the skills and resources to fight the demon who is very much as real as cancer.
    With as much as we pay a month for health insurance, i am stumped as to why it is SO hard to get these things paid for.

  • Marsha Jurgenson (Wednesday, July 18 12 03:52 pm EDT)

    Without our nutritionist/ dietitian, our son may not be here today. She was the one who actually diagnosed him with an eating disorder before any of the M.D.s he had been seeing did. He was a victim
    of exercise bulimia,was undernourished (although he appeared to be eating). This is a very tricky illness, but fortunately our nutritionist diagnosed it in time.Why nutritionists and dietitians are
    not included in medical insurance in my state is abominable, particularly since I attribute our son's diagnosis and survival to the help he received from the nutritionist.





  

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