What Affects Eating Disorder Treatment Costs?
- People with eating disorders experience serious behavioral conditions that adversely affect their quality of life.
- Although eating disorders can be effectively treated, it can be expensive if you do not have insurance coverage.
- Treatment costs for eating disorders will vary depending on the type of treatment you pursue, whether you have insurance, and whether your insurance covers the treatment you choose.
Treatment for eating disorders can, initially, sound incredibly expensive. Unfortunately, we live in a world where healthcare in general is very costly, and treatment for eating disorders can be as expensive as treating any other disease that might enter a person’s life. Often insurance will help, but if not, there are other options out there you should be aware of.
Several factors determine the cost of treating an eating disorder. This includes whether or not hospitalization is necessary, insurance status, type of eating disorder, and which clinicians are necessary to treat you.
So why is treatment so expensive? We’ve gone ahead and done the research so that you don’t have to.
- Eating disorder treatment is a specialized field. Besides having many years of tertiary education, our clinicians are constantly developing and training to stay up-to-date with the latest treatment modalities. Most treatment providers, including therapists, counselors, dietitians, and medical professionals, undergo extensive education and training to specialize in eating disorder treatment. The expertise and experience of these professionals influence treatment costs.
- Multidisciplinary approach: Eating disorders are often treated with a multidisciplinary approach which includes therapy, medical care, nutrition counseling, and medication management. The cost of treatment increases due to the coordination and integration of services among different professionals, which may result in multiple weekly sessions.
- Intensive treatment settings: Inpatient hospitalization or residential treatment may be required for severe cases or when outpatient care is insufficient. Staffing, facility costs, and specialized services in these settings contribute to costs as they provide a highly structured environment and round-the-clock medical supervision.
- Staffing: Providing comprehensive treatment for eating disorders requires the involvement of therapists, nurses, doctors, dietitians, private chefs, and support staff. Many different people are working behind the scenes to make your treatment as smooth and efficient as possible.
- Insurance limitations: Treatment providers may not be reimbursed fully for the costs associated with eating disorder treatment through insurance companies because of limitations in coverage. This can result in higher out-of-pocket expenses for individuals seeking treatment.
- Research and evidence-based practices: As new research and evidence-based practices emerge to address eating disorders, the field of eating disorder treatment continues to evolve. Often, treatment providers commit to incorporating the latest research findings into their practices, which involves ongoing training and resources. Maintaining current best practices contributes to the overall cost of treatment.
- Amenities offered at the center: As part of the overall costs associated with running the center, there are costs involved in maintaining the facilities, equipment, and resources required for treatment. There are many things to consider, including the property, transportation, daily or weekly restaurant outings, or recreational activities in addition to all utilities including electricity, gas, and water. Eating disorder recovery depends heavily on the food served to clients prepared to individual preferences by an onsite chef, which also adds to treatment costs.
If you are beginning your recovery journey, navigating the treatment system can seem daunting. However, it is imperative not to lose hope! Regarding health benefits, receiving appropriate and effective treatment outweighs the financial burden, leading to improved physical and mental well-being, enhanced quality of life, and a greater probability of long-term recovery.
Cost and Levels of Eating Disorder Treatment
To begin discussing how you can pay for eating disorder treatment, let’s first examine the different types of eating disorder treatment available. There are five primary levels of eating disorder treatment, each designed to treat a varying degree of severity. Remember that the more intensive treatment you receive, the more expensive it will be.
Outpatient Therapy: This typically involves regular sessions with a therapist or counselor. Costs can vary depending on the therapist’s expertise and location but range from $100 to $300 per session. Several sessions may be necessary depending on the individual’s needs.
Intensive Outpatient Program (IOP): IOP offers more structured and intensive treatment than an outpatient program. As a result, it requires several hours of therapy and support multiple times a week over several months. Depending on the program and location, the cost ranges from $500 to $1,000 per week.
Partial Hospitalization Program (PHP): This is a more intensive level of treatment where individuals spend most of their day at a treatment facility but return home in the evenings. Depending on the program and location, the cost ranges from $800 to $2,000 daily.
Residential Treatment: In a residential treatment center, clients reside in a specialized facility where they are provided with round-the-clock support and care. Depending on the facility and location, the cost can range from $1,000 to $3,000 per day. The duration of treatment can range from several weeks to several months.
Inpatient Hospitalization: This type of treatment is usually reserved for those who are medically unstable and require immediate medical attention and stabilization. They may suffer from malnutrition, electrolyte imbalance, dehydration, liver and kidney problems, and problems related to blood pressure and heart rate. As inpatient care is provided in a hospital or medically-staffed treatment facility, the costs can be quite high, sometimes averaging around $2,000+ per day.
Due to the cost of higher levels of treatment (residential and inpatient), clients typically spend more time in lower levels of treatment (outpatient, intensive outpatient, and partial hospitalization) due to the lower cost.
Please keep in mind that these are approximate costs and can vary greatly. In addition, insurance coverage can help offset many costs, but coverage varies depending on the insurance plan.
Does Insurance Cover Eating Disorder Treatment?
Eating Disorder Solutions offers a full continuum of care for eating disorder clients. The level of coverage varies depending on the provider’s criteria for admission, the benefits covered, and what plan the member is enrolled in. Many insurance providers will require the client to meet criteria in order to access comprehensive levels of care. These include residential care, partial hospitalization, and intensive outpatient programs.
We believe cost should never stand in the way of reclaiming control over your life and future, and that’s why we partner with many health insurance providers to make eating disorder treatment more affordable. Eating Disorder Solutions is in-network with Blue Cross, Magellan Health, Aetna, and Friday Health Plans, plus we accept most other insurance.
The process of getting your insurance to cover eating disorder treatment can be complex, but there are some general steps you can follow:
Look at your insurance policy: Find out what mental health and eating disorder services your insurance covers by reading your policy documents. Learn about the specific coverage, limitations, and requirements.
Consult a healthcare professional: Contact your doctor, therapist, or psychiatrist, who can diagnose your condition and recommend appropriate treatment options. In addition to helping you document the medical necessity of treatment, they can also communicate with your insurance company on your behalf.
Obtain pre-authorization: Certain health insurance plans require pre-authorization before proceeding with specific treatments or levels of care. Provide your healthcare provider with the necessary paperwork and documentation to obtain pre-authorization for eating disorder treatment. As part of this process, you may be required to submit a treatment plan and medical documentation.
Maintain accurate records: Document all interactions, conversations, and correspondence concerning your insurance coverage. This includes notes from healthcare professionals, pre-authorization requests, claim forms, and denials or appeals.
Take steps to understand your rights: Learn about your mental health parity rights. Essentially, these laws require insurance companies to cover mental illnesses equally to physical illnesses. If you feel your insurance provider is not complying with these laws, you may file a complaint with your state’s insurance commissioner or seek legal counsel.
Don’t be afraid to advocate for yourself: If your insurance company denies you coverage for eating disorder treatment, don’t hesitate to file an appeal against the decision. Review the denial letter carefully, collect any additional supporting documentation you may need, and submit a written appeal within a reasonable time frame. In addition, you might want to consider consulting with an experienced healthcare advocate or an attorney specializing in insurance appeals if you need assistance.
Consider other options: If insurance coverage is not available or limited, it may be possible to find other sources of financial assistance. Treatment facilities or non-profit organizations can offer assistance programs, such as sliding-scale fees, grants, scholarships, or assistance programs.
To navigate insurance coverage for eating disorder treatment, you should stay persistent and become as informed as possible. Seeking support from healthcare professionals and advocates who can guide you through the process as you attempt to cope with your eating disorder will make it much easier for you.
Getting Treatment Without Health Insurance
If you’re worried about the cost or don’t have insurance, it may be possible to alleviate the financial burden associated with treatment by exploring options for financial assistance, such as payment plans, sliding-scale fees or grants.
Many people struggle with eating disorders and may be unable to afford treatment because of a lack of health insurance. As a result, our facility offers financing programs and payment plans to help people become a part of our treatment program and start their recovery journey. With the different levels of care we offer, we can accommodate various budgets and severities of eating disorders. Financing is an excellent option for clients and families who:
- Have no health insurance
- Have healthcare insurance without benefits for treating eating disorders
- Have insurance that covers eating disorders but offers fewer days of inpatient treatment
- Have high co-pays and deductibles
- Have coverage for eating disorder treatment but denied benefits during treatment
It is still possible to have access to eating disorder treatment even if you don’t have health insurance. Several options are available to you:
Sliding-scale fees: There are many treatment providers, such as therapists, counselors, and treatment centers, that offer sliding-scale fees based on the income of the patient. These fees are adjusted according to your financial situation to make treatment more affordable. To learn more about sliding-scale options, you should contact local treatment centers or mental health professionals in your area.
Community mental health centers: Several community mental health centers provide low-cost or free mental health services, including eating disorder treatment. Centers like these may provide therapy, counseling, support groups, and referrals to specialized treatment programs. Ask about the services provided by community mental health centers in your area.
Non-profit organizations: Some non-profit organizations specialize in advocating for and supporting people with eating disorders, and some provide financial assistance or scholarships for treatment. Contact local or national eating disorder organizations for resources and information.
Support groups: Support groups do not provide formal treatment but can provide peer support and resources. There are in-person and online support groups for eating disorders that can provide recommendations for affordable treatment options.
Financing and payment plans: Some treatment providers or treatment centers, such as Eating Disorder Solutions, offer payment plans that allow you to pay for treatment over time. Consider these options when contacting treatment centers to explore more affordable payment options.
Government assistance programs: Find out if you are eligible for government assistance programs such as Medicaid, Medicare, or other government-sponsored healthcare options.
It’s important to note that while these options may help make eating disorder treatment more accessible, they may not provide the same level of comprehensive care as private health insurance. Regardless of where you are in your recovery, it is essential to understand these insurance nuances to advocate for the treatment you deserve. You are strong and capable of shaping your future.
Reach out to speak with one of our experts.
Contact our admissions team directly if Eating Disorder Solutions seems like a good fit for your recovery. Our specialists can advocate for your best interests to ensure you are able to maximize your benefits. We can also answer any questions you have about payment plans or other financial options. Don’t let finances prevent you from getting the help you need.
Not sure whether your insurance covers eating disorder treatment? We can help. Call us at 855-808-4213 to quickly and confidentially verify your benefits, or submit the form here.
