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Does Insurance Cover Teen Eating Disorder Treatment?

 

eating disorder spelled out

There is an overabundance of health insurance companies available in America, and within each company a myriad of different (often tiered) healthcare coverage plans are offered. Each plan has extremely specific details surrounding the exact types of medical services that will be considered eligible, which indicate what services will be covered under the plan. Each plan will have a different monthly premium fee, and in many cases if a monthly premium payment is missed the plan is terminated. Some plans cover a portion of fees associated with obtaining services from an out-of-network provider, and some do not. Each plan has different co-payment fees for different services (e.g., filling a prescription, a specialist visit, surgery, a primary care visit, etc.). Insurance is complicated, and insurance companies change the fine printed information yearly. In short, yes, due to the Affordable Care Act medical insurance companies are obliged to cover teen eating disorder treatment, but the type of treatment covered can be incredibly specific and an insurance company can elect to offer coverage only for a small set of approved treatment options. 

Affordable Care Act Basics

In 2010, President Obama signed the ACA (Affordable Care Act) into federal law. The purpose for signing the ACA into law was threefold: to create affordable health insurance coverage, enabling more individuals to obtain healthcare; to expand the Medicaid program; and to support “innovative medical care delivery methods designed to lower the cost of health care generally.” Prior to the passing of this litigation, insurance companies were not obligated to cover pre-existing conditions (e.g., eating disorders, substance use disorder, etc.). The ACA requires all health insurance plans to provide coverage for pre-existing condition. Furthermore, the ACA stipulates that health insurance companies are obligated to provide similar coverage for the treatment of all diagnosable mental illness. 

Eating Disorders

Eating disorders are serious mental illnesses. They are characterized by abnormal, irregular eating habits, and an extreme concern with one’s body weight or shape. There are several different manifestations of eating disorders. The various types are listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) under the Disorder Class: Feeding and Eating Disorders. The three most common eating disorders are anorexia nervosa, bulimia nervosa and binge-eating disorder. Eating disorders can be debilitating and can adversely affect a young person’s emotions, health, and interfere with one’s ability to adequately function in his or her daily life. If left untreated, eating disorders can result in severe short and long-term consequences. 

Treatment

There are a variety of treatment options for teens struggling with eating disorders. To secure the most effective treatment it is essential to obtain an accurate diagnosis. Every teenager is different and will respond distinctly to the various eating disorder treatment methods available. It is common practice for a customized treatment plan to be developed that considers and addresses each person’s nuanced needs. The treatment plan for an adolescent diagnosed with an eating disorder will be directly informed by several contributing factors, such as: the exact diagnosis, how long he or she has been actively engaging in unhealthy eating habits, his or her personal health history, and the presence of any co-morbid disorders. The goal of treatment for teenagers with an eating disorder is to help them find a healthy and sustainable relationship with food. While eating disorders are life-long conditions, with proper treatment, a teen can learn how to effectively manage its symptoms. 

For Information and Support

Seeking help is never easy, but you are not alone! If you or someone you know needs mental health treatment, we strongly encourage you to reach out for help as quickly as possible. It is not uncommon for many mental health difficulties to impact a person for the long term. The earlier you seek support, the sooner you and your loved ones can return to happy, healthy, and fulfilling lives.

Our admissions team is available to answer any general questions regarding mental health issues, treatment, and/or specific questions about the program at Pacific Teen Treatment and how we might be able to help your family. We can be reached by phone 24/7 at 800-531-5769. You can also contact us via email at info@pacificrtc.com.

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