Stupid insurance

[Nikia]

I finally got up the courage to look into the residential eating disorder program that my therapist recommended. I answered all the questions on their assessment. I am planning on getting their required lab work at my doctor's appointment next week. They checked my insurance for me to see if it would be covered. The residential program is not covered at all and would be completely unaffordable (2 months treatment at a cost of more than I make in a year). They also have a day treatment program. Eight days of the 20 or more days of treatment would be covered. Each additional day is $450/day at my cost. Even if we could come up with the money, this place is a significant commute (more significant than I probably could drive everyday)and we don't know anyone there who I could stay with.
I did manage to call the National Association for Anorexia and Related Disorders. They did have the name of one therapist specializing in this in the entire area, although I am almost out of outpatient counseling coverage for the year. Evidently this therapist does lead a free support group, but it only meets once a month.
Why couldn't I have been an alcoholic or drug addict? There are lots of counselors and support groups for that in the area. My place of business will even pay for inpatient treatment for that. No offense to DUers or DUers loved ones with those problems. I am just frustrated right now.

[progmom]

1. that sucks, i am sorry

:hug:

you do need help, and it is not cool that you are having such trouble finding it.

good for you that you are able to recognize your need for help, though. don't give up. this is a great first step. :hug:

i am sorry i didn't see this before.

[Nikia]

3. Thanks for your support

I really appreciate it.

[yellowdogintexas]

12. and by golly, I hope you get the help you need, and hang int

there ...you know you have friends out here!!!!!!

[valis]

2. Nikia, you rock. Keep trying, keep looking. OK?

:hi:

[Nikia]

4. Thanks

I talked this over with my husband more. The hospital near his parents might have a similiar day treatment program (They did when my husband was in high school because one of his classmates received treatment there). Even if it isn't cheaper, at least I would have a place to stay if his parents would be cooperative and not give me a hard time. I'd have to admit to them that I have this problem, but I have admitted it to my husband, a close friend, and DU. Even harder, would be admitting it to my own parents. If I do go in for intense treatment which will keep me away from work, I'll probably be admitting it to my boss too, which is also scary. Living this way is scary though too.

[bertha katzenengel]

5. dear Nikia

I am so very sorry. It is extremely frustrating, isn't it, when eating disorders are not taken as seriously as other health problems?

:hug:

[Nikia]

6. It is frustrating

I think that the insurers think that it is something simple that one just has to resolve by oneself or something. I know that my eating disorder defies logic. Despite this, I haven't been able to fix it. It has gotten out of my control. The truth is that most mental health problems aren't taken quite as seriously by insurers as other health problems. I think that drug and alcohol dependency has gotten more legitemacy as a health problem through the efforts of organizations that have raised the issue, some in response to the criminality of drug crimes and crimes realted to alcohol use. I don't know what it will take for eating disorders to get more attention.
Thanks for your support.

[bertha katzenengel]

7. I DO support you, absolutely.

I've got one too but my eating disorder isn't as debilitating. Nearly 20 years ago I spent two months in a mental hospital for depression. The hospital had a ward for women with anorexia and bulimia, and I saw what they went through. My therapist of 13 years back home - her specialty is eating disorders. She fights through her professional organizations for better medical recognition of what we live with.

Our disorders kill women like us every day, but that's not enough. :shakinghead: I just don't know what to do.

Except to support other folks w/ the same struggles. :hug: Be well.

[Nikia]

8. Thanks again

I support you in your struggle too. You are right that we need to support each other.

[giant_robot]

9. I sometimes wonder why we have health insurance when it's never

there when we need it. Eating disorders are tough to get over, and I sincerely hope you get the treatment you need.

On a lighter note, I clicked on the link because I thought you were talking about "stupid insurance" as opposed to "health insurance". You know, the kind of insurance the stupid people in those Vonage commercials could use (woo-hoo! woo-hoo-hoo!). I don't think stupid insurance would necessarily be a bad idea, although it would surely bankrupt insurance companies! :P


edit: Typo! Maybe I need stupid insurance.

[Nikia]

10. Maybe I should have used a different title

I was rather upset about it last night though and probably wasn't thinking as well as I should have been.

[yellowdogintexas]

11. this type of disorder (and most mental health issues) are

virtually ignored by most medical insurance packages, with few notable exceptions.

More than likely if you have a plan which covers any type of mental health, the coverage you would have for actual injury, acute illness, etc. is fairly decent. Of course I could be wrong I have seen some pretty sucky policies in my time

Certain states mandate above average coverage for their residents and if you issue policies in their states, you gotta cover it.

Which is why drug and alcohol has better coverage: many states have mandated it.

I know this because I worked on the policy admin side of health insurance for over 20 years. Rule of thumb: the larger the employee base in the group, the better the plan.

which is why if the stupid people who run the insurance companies would just wake up and realize that the ever how many million uninsured working people would be one fantastic group if they could be pulled together. The percentage of basically healthy young people would skew the stats so nicely that the coverage could actually be decent.


But nobbody everlistens to me.

[MidwestMomma]

13. Are you saying your insurance won't pay for inpatient treatment for eating

disorders? Or is it that there are no inpatient hospital programs in your area?

Most plans will pay for inpatient treatment at a hospital and usually you get 30 days a year for that. I'm guessing they won't cover the residential treatment because most insurance plans don't cover residential treatment facilities.

One suggestion is if you can find an inpatient treatment plan even in another part of the country, it might be worth the travel expense in order for your insurance to cover it. And maybe you can find a really good program. (That's the most important thing.)

Of course it completely SUCKS in this country that you have to make decisions about what's best for your health based on your insurance policies provisions because we don't have affordable health care for everyone. :(

I work in in health insurance so PM me if you want. I know a lot about this stuff and would be glad to help you figure out how to get this covered by your insurance.

In the meanwhile, I'll send good thoughts your way....