Insurance Update

The CPN article observes that the Senate bill does not require plans to provide parity for substance abuse coverage. This issue is of considerable importance to anorexic patients because many of them have a history of drug and alcohol problems.

According to insure.com , as of May 2000, 31 states had parity statutes with widely varying provisions.

State legislation covers substance abuse in Kentucky and Vermont, but not in Arizona, Indiana, Maine, New Jersey, New Mexico, or Tennessee. Massachusetts and Missouri parity statutes include substance abuse only if it stems from a mental illness.

State employees are covered in Indiana and Louisiana, but not in Arkansas. North Carolina covers only state employees.

In Arkansas, there is a small business exemption for companies with less than 50 employees, while in Maine the exemption is limited to employers with a staff of less than 20. California's statute, on the other hand, has no small business exemption at all, and New Hampshire covers group plans and HMO's regardless of size.

There are also a number of special provisions peculiar to individual states. For example, Hawaii's parity statute only covers schizophrenia, schizoaffective disorder, and bipolar disorder. By contrast, Vermont covers any condition involving mental illness and provides comprehensive coverage of deductibles and out-of-pocket expenses.

While the Domenici-Wellstone bill would cover severe conditions, at least one state is considering legislation which would apply to milder cases. According to a February 9, 1999 article in The Daily, the Washington State Legislature has conducted committee hearings on a bill that would require insurance companies to cover treatment for eating disorders in their early stages. According to the article, Dr. James Farrow, director of the University of Washington's adolescent medical program, said that there would be far fewer instances of severe anorexia and bulimia nervosa if insurers paid for early-stage care.

For suggestions on what to do when insurance companies refuse to pay for treatment, and a sample letter regarding same, visit the website of the Academy for Eating Disorders. Although unrelated to insurance, readers may be interested in an article in the Academy's Fall 2000 Newsletter, also available online, about the eating disorders documentary "Dying to Be Thin." The program will air December 12, 2000 at 9:00 p.m (EST) on NOVA/PBS. Directed by Larkin McPhee (who authored the article), it contains case studies of eating disorder sufferers ranging in age from 12 to 56.

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