Let’s be honest, insurance is a total headache. Health insurance is purchased for the sole purpose of financial support for the consumer’s medical needs, but what insurance companies don’t explain is how much treatment will actually cost or what specifically they will cover. For most people, insurance is something done at the beginning of a new job, during a divorce, after getting married, or the new year. Confusing terms like EPO, HMO, PPO, and POS are sprinkled around and danced over.
Every company is different and every policy is different. These policies are typically tailored to fit the needs of current situations, not future situations. Although a lot has been enhanced in the past five years, less consumers can actually understand the full scope of their insurance plan. When signing up for a plan we don’t usually want the cheapest option, but we also don’t want the most expensive plan either, so we settle for the in-between. We are told vague terms, vague lingo, and have a vague understanding of the actual contents of the plan, usually never speaking to a live person.
Then you have options for deductibles, out of pockets, co-pays and everything is dependent on who/what is going on. Insurance companies accept claims for treatment, a clinical professional will make a recommendation on treatment plans, like 30 days residential care, insurance will then either approve or deny the suggestion with regular check ins for progress. So why is an insurance company deciding on how much treatment is enough treatment for your loved one, or for yourself?
The insurance company has never seen you, nor are they medically board certified( although they often may have someone who is certified on staff, they haven’t met you). Insurance companies have a policy number associated with the account- they don’t even know our names yet these are the people making the decision on whether we need medical care. It’s simply not right.
Now you’re thinking something along the lines of “well what am I supposed to do about it?” Let’s take medical care back into our own hands! Investing in yourself financially, emotionally, physically gives a better success rate for those in treatment. It allows the medical professionals to assess how much time is actually needed to be in treatment, allows the client in treatment to decide whether they are truly ready to get out of treatment. Insurance is great to have as a support tool, but insurance doesn’t know what is best for the specific situation. Investing in mental health is the most important investment we can make right now.
I don’t know about you, but I simply cannot pay out right for all the medical care I need, so yes I too use insurance. I use it to get started in treatment, with the understanding my insurance may not cover the full cost of treatment my clinical team and myself may discuss. Yes I met my deductible, co-insurance, and out of pocket, which is good it means that insurance will cover a 100% of treatment, but they have to decide what medically I need, not what I, or my clinical team, feel I need. Now you’re thinking “hold up what do you mean?” I mean insurance can decide I need one week of intensive outpatient care, when my clinical team, who see me on a regular basis and do therapy with me, are suggesting a higher level. So I have a choice, go with what insurance is suggesting or go with what my clinical team is suggesting. Well it seems like a no brainer- I of course want to listen to the people who I see everyday. By choosing that option though it means I need to pay out of pocket, which can get tricky for sure. Luckily though most treatment providers offer payment plans and options that fit the majority of clients.
The clinical team isn’t about making money, no one goes into a service job of understanding an individual’s past trauma, current struggles in attempting to help them overcome a mental health disorder for the money. We have staff members who are simply brilliant, if they wanted to just make money they would be engineers-however they are called to a higher purpose then making an income. Some of our staff have friends and family who have struggled with eating disorders and feel called to help those in need. These are people who truly want the best for you.
Eating Disorder Solutions never wants finances to be a barrier for treatment, everyone should be given the chance to recover!