Does Insurance Cover Eating Disorder Treatment & Therapy?

Are Eating Disorders Covered by Insurance?

The majority of insurance policies cover some type of eating disorder treatment. However, your insurance plan, the state in which you live, and the severity of your disorder determine the amount of treatment covered.

For example, if your weight is not low enough to treat anorexia, or if you have had no medical concerns from bulimia, eating disorder therapy insurance coverage may be denied.¹

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Are Eating Disorders Covered by Insurance?
How to Verify Insurance Coverage for Eating Disorders?
Types of Eating Disorders & Treatments
Medicaid & Medicare
How Much Does Eating Disorder Treatment Cost?

How to Verify Insurance Coverage for Eating Disorders?

With three outpatient eating disorder treatment clinics in Tennessee, Athena Care is in-network with most major insurance plans. To determine your eating disorder health insurance coverage details, call your insurance provider or contact us below.

Types of Eating Disorders & Treatments

Eating disorders are a group of conditions characterized by excessive food and weight difficulties. Still, each disorder has its own set of symptoms and diagnostic criteria.² Below are the symptoms of six of the most common eating disorders:

Anorexia Nervosa: Anorexia is defined by an abnormally low weight and a strong desire to avoid gaining weight or overeating.
- Behavior associated with this eating disorder aims to prevent weight gain at all costs, frequently to the point of malnutrition. Even though the body weight is well below normal, a person suffering from anorexia may perceive themselves as overweight.
Bulimia Nervosa: Binge eating followed by purging characterizes bulimia. When you have bulimia, you may feel guilty or powerless after consuming a significant amount of food. As a result, you attempt to vomit it up.
- To expedite the passage of food through the digestive system, one may utilize laxatives. One may also over-exercise to avoid gaining weight due to eating. One may believe they’re overweight even if their weight is average, slightly over normal, or below a healthy weight.
Binge Eating Disorder: Binge eating disorder, or BED, is a condition in which you regularly overeat. One might also feel terrible about bingeing or as if it’s out of their control. Persons suffering from BED may eat long after full, even to the point of discomfort or nausea.
Pica: Pica is a disorder in which someone eats non-nutritive objects or substances not regularly consumed in society. Pica lasts at least one month, and the foods one may eat include the following:
- Hair
- Chalk
- Rocks
- Dirt
- Cloth
Rumination Disorder: When one regularly regurgitates food without having another medical or gastrointestinal disease, they are said to have rumination disorder. After regurgitation, one can chew and swallow the food again or spit it out.
Avoidant/Restrictive Food Intake Disorder: Previously referred to as “Selective Eating Disorder,”³ Avoidant Restrictive Food Intake Disorder (ARFID) is comparable to anorexia in that both illnesses limit the amount and/or types of food taken; however, unlike anorexia, ARFID does not involve any concern about body form or size nor does it involve anxieties of being obese.

Symptoms of an eating disorder vary by disorder; however, the following are the most common:

An inconsistent diet
Abnormally low or high body weight
Desire to eat alone or secretly
Using the bathroom frequently after a meal
Obsession with losing or gaining weight quickly
Preoccupation with physical appearance and others’ perceptions of one’s body
Feelings of guilt and shame about one’s eating habits
Experiencing abnormal stress or discomfort about one’s eating habits

Eating disorder treatment is based on the type of disorder and the symptoms you’re experiencing, though it usually consists of a mix of psychotherapy, nutritional counseling,⁴ medical monitoring, and, in some instances, medication. Unfortunately, there is currently no medication that fully treats an eating disorder. However, some drugs, like antidepressants or anti-anxiety medications, can help you manage the symptoms of anxiety or depression, which may be creating or exacerbating your eating disorder.

Other health issues brought on by an eating disorder must be treated. If left untreated for too long, they can become severe or even life-threatening. If your eating problem does not improve with standard treatment or poses a health concern, you may be admitted to a hospital or similar inpatient facility.

If your condition has become life-threatening, your doctor may assess your nutritional intake, refer you to an eating disorder specialist, or admit you to the hospital. In addition, intensive outpatient programs (IOPs), outpatient, partial hospitalization, residential treatment, or inpatient treatments may be necessary.⁵

Furthermore, psychotherapy, such as cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), or another form of therapy treatment, may be able to address what is producing your disorder in some situations. Stress reduction through yoga, meditation, or other relaxation practices can also aid in managing an eating disorder.

Taking a systematic approach to eating disorder treatment can help you manage symptoms, regain a healthy weight, and keep your physical and emotional health in check.

Medicaid & Medicare

Medicaid and Medicare usually require outpatient treatment before moving on to a higher level of care. Inpatient treatment, which is often done in a hospital setting and focuses on medical stabilization, is typically covered after other forms of treatment have been tried. There are, however, limitations on the length of treatment programs covered under Medicaid and Medicare insurance policies.

How Much Does Eating Disorder Treatment Cost?

Treatment might range from a few sessions with a therapist to an inpatient hospital stay. The most expensive option is to remain in a hospital or a residential institution.

A two-week inpatient hospital stay for eating disorders treatment can cost more than $19,000 without insurance. A one-month stay in a residential institution with rigorous therapy costs more than $1,200 each day.

Some of the above expenses may be covered if you have eating disorder insurance coverage. Individual costs for visits to physicians, therapists, dietitians, therapy sessions, and drugs are often included in outpatient care. In addition, some treatment facilities allow a sliding scale payment plan.

Sources

Kritz, Fran. “How Much Does It Cost to Treat Eating Disorders, and How Can I Pay for It?” GoodRx Health, GoodRx, Inc., 30 Aug. 2021, https://www.goodrx.com/conditions/eating-disorders/eating-disorders-treatment-costs.
Petre, Alina M. “6 Common Types of Eating Disorders (and Their Symptoms).” Healthline, Healthline Media, 18 May 2022, www.healthline.com/nutrition/common-eating-disorders#-1.-Anorexia-nervosa.
National Eating Disorders Association. “Avoidant Restrictive Food Intake Disorder (ARFID).” National Eating Disorders Association, 22 Feb. 2018, www.nationaleatingdisorders.org/learn/by-eating-disorder/arfid.
Mayo Clinic Staff. “Eating Disorder Treatment: Know Your Options.” Mayo Clinic, Mayo Foundation for Medical Education and Research (MFMER), 14 July 2017, www.mayoclinic.org/diseases-conditions/eating-disorders/in-depth/eating-disorder-treatment/art-20046234.
“Types of Treatment.” National Eating Disorders Association, 16 Nov. 2020, www.nationaleatingdisorders.org/types-treatment.