Using Healthsmart for Eating Disorder Treatment
Healthsmart insurance is a leading industry provider of health care solutions for the private sector and small businesses. The company focuses on helping you reduce medical costs and improve your overall health.
Using Healthsmart for Eating Disorder Treatment
If you are using Healthsmart as your primary insurance company for benefits, you will probably have to pay out-of-pocket for at least 20 percent of the total cost for treatment for an eating disorder. For addiction issues, your Healthsmart insurance plan may not cover the entire cost of rehabilitation. You should contact the facility you intend to use to see if you can work out a payment plan for the remainder of the cost of treatment. You may have to provide a down payment before you begin treatment, or you may be required to pay the cost of treatment in full if your insurance company does not cover it.
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Will Healthsmart Cover Eating Disorder Treatment?
Trying to determine what your Healthsmart insurance company will cover and what it will not cover can be challenging. While most insurance plans will cover the cost of eating disorder rehab, it is best to check with your Healthsmart agent to find out what your policy covers so you aren’t left with a large bill that you cannot afford to pay.
Inpatient care for an eating disorder is usually limited to 25 days and, during this time, your policy will cover up to 80 percent of the cost of treatment. It will also cover up to 20 outpatient visits. To find out exactly what your policy will cover, you should call the number on the back of your insurance card and speak to one of the knowledgeable Healthsmart representatives.
If your policy does cover an eating disorder treatment program, you will need to get a referral from your primary care physician or mental health professional in advance before you start treatment. At this time, you can ask for a referral to someone who will take payments, or ask your doctor to recommend someone who is not terribly expensive.
How Much Will Eating Disorder Treatment Cost?
The cost of treatment for an eating disorder can be extremely expensive because it is not an illness that can be treated overnight. Like many behavioral health illnesses, the stay in an inpatient treatment program can last for several months, and the average cost of a rehabilitation program can cost between $20,000 and $30,000 per month, depending on the types of services you need. You also have to add in the cost of travel to your total cost, because usually a treatment program takes place far from your hometown, away from the stressors and triggers that contributed to the illness.
Inpatient treatment fees cover physical or occupational rehabilitation, therapy, fulltime access to a physician and other health professionals, training and alternative methods of treatment including acupuncture, exercise, massage therapy and nutritional counseling. The cost of treatment is also higher if you have a dual diagnosis and must pay for detox or drug addiction rehabilitation.
Outpatient programs are slightly cheaper because you can return home to your family each night. This type of treatment is often preferred for individuals with young children who can’t be gone for lengthy periods or for executives who have a business to run during the day. The cost is around $10,000 a month, and additional costs may include prescriptions and counseling.
Even after treatment has been completed, there are still incurred costs for additional care. An individual who has suffered from an eating disorder can require several years of follow-up care to ensure there is no recurrence of the illness. Many Healthsmart insurers will not cover the cost of long-term care because eating disorders are often hard to diagnose, difficult to treat and the insurance company is sometimes ill informed on which treatments work the best.
Inpatient Eating Disorder Treatment vs. Outpatient Services
Eating disorders can affect both your physical and mental well-being. Often a person with an eating disorder shows no outward signs of the illness. Those suffering from anorexia have a poor body image and see themselves as overweight even when they are severely underweight. They may also have an obsession with food and exercise. Other symptoms to look for include:
- Constant fatigue
- Protruding bones
- Thin hair
- Refusal to eat
- Refusal to admit feelings of hunger
- Extreme eating rituals such as cutting food into tiny pieces or spitting food out after chewing
Inpatient treatment is often reserved for severe or life-threatening cases of the illness, because the individual requires a constant level of care to prevent self-mutilation or even suicide. The main goal of inpatient eating disorder treatment is to stabilize the individual, to assist in self-acceptance and to change the irrational eating behaviors. Stabilization is usually done through intravenous nutritional replacement, although, if the person fights this treatment, a nasogastric tube may be inserted through the nose and into the stomach.
If left untreated, eating disorders can cause a slow heart rate or low blood pressure, osteoporosis, muscle loss, dehydration, hair loss and overall weakness. Because the effects of eating disorders are so severe, inpatient treatment is often the most recommended method of treatment. Cardiac monitoring is often done until the patient has remained stable for several days, because those at risk from severe starvation are susceptible to cardiac failure.
Intensive outpatient care is generally only recommended when a person with an eating disorder is emotionally self-supporting and maintains healthy eating habits. At this stage of the treatment, you may return to school or work and can make rational decisions. You may also begin to choose your own meals again, and you can be left alone without fear of harming yourself. With outpatient care, you can return to your home every night and begin attending a self-help program or 12-step recovery program. Outpatient care is most beneficial to someone who still needs the continued support of those going through the same recovery process, and this care is usually covered by your Healthsmart plan.
Dual Diagnosis Eating Disorder Therapy
According to the Journal of American Medical Association, nearly half of all individuals who suffer from an eating disorder are also diagnosed with addiction problems. This is generally due to poor self-esteem and the desire to escape from one’s life. Alcohol and drug addiction can make an eating disorder more difficult to treat, so it’s important to locate a facility that deals with eating disorders and substance abuse together. Inpatient treatment is also recommended for a dual diagnosis because you will need constant care for the addiction and withdrawal symptoms.
The first step in the dual diagnosis eating disorder treatment when substance abuse is the co-occurring issue is detoxification from drugs or alcohol. This can take several days to several weeks, depending on the severity of the addiction. Prescription drugs may be needed to help you get through the withdrawal symptoms, and you may prefer to sleep as much as you can. This stage in the treatment process also requires constant care to monitor your blood pressure and other vital signs. You may feel out of control of your circumstances and believe that one way to regain control is through your eating disorder. Generally, your physician will prescribe medications to help deal with the feelings of withdrawal, and you will receive one-on-one counseling.
Once you get through the initial detox stage, you can begin the process of rehabilitation. Your therapist may use cognitive behavioral therapy to help you learn how to deal with stress and anxiety, and to help you learn the emotional triggers of both the drug or alcohol abuse and the eating disorder. Cognitive behavioral therapy also helps make it easier for you to eat properly, gain weight and regain a healthy lifestyle.
All efforts during dual diagnosis therapy will focus on getting you to a healthy weight and getting you off the drugs or alcohol. If your physician determines that depression is a factor in your addiction, you may be placed on antidepressants to help stabilize your moods. Other treatment methods can include group therapy with others going through similar circumstances and family therapy, which will help loved ones learn how to deal with the dangers of an eating disorder. Family therapy also teaches family members about what to look for as far as relapse goes.
Insurance vs. Private Pay for Eating Disorder Options
Nearly all Healthsmart insurance plans pay for part or all of an eating disorder treatment program. This is because of the overall health effects of the disorder. For someone who requires long-term care, that is where insurance coverage stops. If you have suffered from an eating disorder your whole life, you have probably need to pay out of pocket for a good portion of the treatment costs.
Early diagnosis is a big help in treatment, so it’s important to recognize the symptoms early on. Like most addiction and behavioral health issues, the earlier you diagnose the problem, the easier it may be to treat.
If your insurance company will only pay for part of the treatment, there are some things you can do to help cover the costs. First, ask your physician if there is anything you can do at home to aid in rehabilitation. If it is your child who suffers from the disorder, you may opt for a family-based treatment program. This allows you to monitor most of the treatment at home and report back to your physician.
Some hospitals and clinics offer free treatment to those suffering from eating disorders. There may be income limits, but you should ask your physician if there is any community help you could take advantage of. Local clinics are often established by volunteers in the community to provide free health assistance, based on income, to those in need.
For those left to pay for treatment on their own, financial assistance may be the answer. Many clinics and doctors will allow you to make payments on treatment, and you may be able to finance your inpatient treatment program if you talk to the financial department of the program. The important thing is not to ignore treatment simply because you cannot afford it or because your Healthsmart insurance won’t cover it. Ask around to discover any options that are available to you.
If you or someone you love suffers from an eating disorder, the sooner you get help the better. Contact us at for more information on locating the best treatment center near you.