GEHA Health Plans Eating Disorder Coverage
Government Employees Health Association (GEHA) is the second largest health plan and dental plan provider across the United States, serving federal retirees, federal employees and their families. The company offers benefit plans to over 1 million members all over the world.
As a nonprofit and self-insured association, GEHA Health Plans does not require payment dues from its members. For the time being, it does not collect membership fees. As a member-centric organization, it allocates 94 cents for every dollar it receives for members’ health benefits.
Using GEHA Health Plans for Eating Disorder Treatment
GEHA health plans may cover some or all of the cost of care for eating disorder treatment. You can become a member of Government Employees Health Association, Inc. if you are an annuitant or a federal employee who is qualified to join the Federal Employees Health Benefits program. To enroll, simply fill out Standard Form 2809 (the Health Benefits Registration Form).
For clients with limited resources and income, financial assistance for paying the Medicare prescription drug plan is available. To learn more about this program, you may visit the website of the Social Security Administration (SSA) or call our helpline at
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Does GEHA Health Plans Cover Eating Disorders Rehab Programs?
Yes. GEHA Health Plans covers rehab for eating disorders as provided in the GEHA Benefit Plan brochure under section 5(e), entitled Mental Health and Substance Abuse Benefits. While some organizations do not include eating disorders among the list of mental health problems, the mental health charity organization called Mind does.
Under section 5(e), you have two options concerning your eating disorder treatment: in-network or out-network. Just make sure to secure approval first for inpatient residential, inpatient hospital or intensive day treatment services. Note that limitations and cost sharing for substance abuse and mental health benefits should not exceed those for other conditions and illnesses.
The following points are the most important things to understand regarding these benefits:
- All benefits are subject to the limitations, definitions and exclusions specified in the GEHA Health Plan guide and are compensated only after the network concedes that the treatment is medically sound.
- The yearly deductibles are the following: $1,500 for self-only enrollment and $3,000 for self and family enrollment. These deductibles can be fulfilled by one or more members of the family and apply to all benefits under section 5(e).
- Your traditional coverage kicks in only after you have paid your deductible.
- Under the traditional medical coverage, you have to bear the coinsurance amounts for qualified prescriptions and medical expenses
The above points are just some of the provisions contained in section 5(e) of the GEHA Benefit Plan brochure. To learn more about what is in store for you in this plan, give us a call at .
Inpatient Treatment Length GEHA Health Plans Will Cover
Inpatient care for an eating disorder requires prior authorization. Before contacting your insurer, you and your team of health care professionals need to devise a treatment plan that is tailored directly to your specific needs. You will sit down in a private room to talk about how to handle your case best. Your team of health care professionals will recommend a treatment duration that it deems sufficient to address your eating disorder; the proposed length of treatment will have to be approved by GEHA Health Plans.
If you need help finding out if your health insurance really covers your eating disorder treatment, feel free to call our helpline at . We are available 24/7 to answer your call.
GEHA Health Plans Coverage for Eating Disorders With Dual Diagnosis
Individuals with eating disorders are 50 percent more likely to engage in drug or alcohol abuse, compared to 9 percent of the general population, according to the National Institutes of Health. If this is your case, your dual diagnosis is best treated by a team in an inpatient setting with the expertise to deal with comorbid disorders such as substance abuse and any eating disorder.
The good thing about inpatient care is that it allows you to be monitored by clinicians continuously, that is, 24 hours a day, so any problem that might arise can be addressed immediately. This is ideal for patients with dual diagnosis eating disorders, because the staff at the facility will be able to regulate your food intake and control the adverse effects associated with your withdrawal symptoms or side effects of other conditions.
Treatment for a dual diagnosis involving substance abuse typically begins with detox to cleanse your body of harmful chemicals. The next part of treatment is therapy, wherein you will work closely with a therapist, and you will receive group therapy, cognitive behavioral therapy, talk therapy or a combination of these. Cognitive behavioral therapy trains you to respond well to anxiety or stress in various ways, making you capable of avoiding improper eating habits and substance abuse triggers.
Eating disorder rehab programs are designed to help you get into healthy physical shape and to an ideal weight. This can ease several side effects incidental to your withdrawal symptoms, such as tiredness and dizziness or anything else you might be battling. Medications may be given to treat your depression or anxiety.
If you are wondering whether you or someone dear to you has comorbid substance abuse and an eating disorder, seek professional assistance. To get connected to a knowledgeable medical advisor, call our helpline at .
Specialty Eating Disorder Treatments Using GEHA Health Plans
GEHA Health Plans has access to a large network of health care providers in the country. While some patients will be happy with the normal type of treatment at a standard facility, others may require care at an executive or luxury facility. If you belong to the latter group, you can expect the following exclusive offerings:
- Swimming pools, steam rooms and spas
- Private rooms
- Gourmet cuisine
- Laundry service
- Horseback riding and other exciting activities
- Landscaped gardens and professionally decorated rooms
Although you are not going to enter such a facility for vacation, fancy amenities might prove helpful if your treatment at an inpatient facility is long-term, spanning several months. A luxury treatment center is particularly designed to suit the needs of high-level business professionals who require high-class service and amenities. With this type of care, you can continue interacting with your business partners and clients and working on your projects while striving to recover from your eating disorder.To learn more about the benefits of using GEHA Health Plans for eating disorder treatment, give us a call today.
If you want to find out if specialty eating disorder treatment is covered by your plan, please feel free to contact us through our helpline at .
How to Cover What Insurance Doesn’t Pay For
Several treatment centers give their clients the chance to work out a payment plan so they can afford treatment. Co-financing is another option you might want to look into. If you don’t have any insurance or not enough insurance to cover your eating disorder treatment, the only option left for you is to obtain treatment by paying out of pocket. Because your life is at stake here, this is surely not a wasted investment.
Verify Insurance Coverage and Find the Best Treatment Programs
Health care providers want to make sure their rendered services are compensated, so expect to have your health insurance subjected to verification. First, they will require you to present your health insurance ID containing a photo of you and the name of the association that provides your insurance. To confirm your membership and coverage, they will contact your insurer either by phone or through a computer-based system. They are interested in finding out if you have paid your premiums and what the total amount of coverage may be for treatment. Your physician may also ask you if you have secondary insurance and verify it in much the same way that your primary insurance is verified, highlighting the specific percentages and amounts covered by the secondary insurance.
Before you come to a conclusion that you have enrolled in the best eating disorder treatment program, you need to fully understand what kind of treatment your eating disorder requires. The most effective treatment usually combines psychological counseling or psychotherapy with attention to nutrition and medication. Ideally, care should be catered directly to your specific needs, and this could vary based on your strengths, problems and needs.
If you think verifying your insurance coverage and finding the help in treating your eating disorder will require much legwork, we are here to make the process much easier. Let us show you what we can do by calling us today at .