Insurance for Eating Disorders

Posted by Lori Henry Sep 6, 2006

A New Jersey insurance company is being battled on how it classifies Anorexia Nervosa. Presently, coverage in most states is limited to 30 in-patient days, a blink in the recovery process, even though the disorder has the highest mortality rate of any mental illness.

The issue is based on whether Eating Disorders are considered "biologically based," like mental illnesses like schizophrenia, depression and other psychiatric disorders. But organizations such as Horizon Blue Cross Blue Shield of New Jersey, who are in agreement with most other insurance companies in the state, defends that there is no conclusive evidence that Anorexia is biologically based.

Mother, Dawn Beye, is gaining support from nearly a dozen of the most well known experts on Eating Disorders for her fight for treatment for her 15 year old daughter. The insurance appeal will be reviewed before an independent panel, which is expected to rule next week.

One of her supporters, Scott Craw, a psychiatrist at the University of Minnesota and one of the past presidents of the Academy of Eating Disorders, wrote a letter stating, "(Horizon)" could only have reached such an opinion through willful ignorance of the scientific literature."

Another is Wade Berrettini, who wrote an article in the American Journal of Human Genetics that Horizon is basing their decision on. It states that there is evidence suggesting the susceptibility gene for anorexia. But he says in a letter, "This is an entirely inappropriate interpretation of my work and the work of our group...It is my opinion that anorexia is biologically based. Dozens of researchers across the world are making an extraordinary effort to find genes which predispose individuals to anorexia."

But not everyone agrees that Anorexia should be covered. Critics state that professionals who lobby for Eating Disorders to be considered biologically based make their livings treating people with diseases. They are charged with thinking only of how it could affect their "business."

Dawn Beye is now paying out-of-pocket for her daughter's treatment at an out-of-state facility. She expects to go more than $200,000 into debt for the recovery, as her daughter has relapsed to a point where her heart rate dropped to dangerous levels, her extremities turned blue and Doctors have been declaring that she needs urgent long-term care immediately.

With other paying fees like $1,200.00 a day for hospital treatment, how many other people have to die before Eating Disorders are recognized as the deadly diseases that they are.

Read the follow up blog here.