Though I hated being there at the time, I was lucky my mother’s insurance (she was a teacher, and had excellent medical coverage) covered my nearly year-long stay at St. Claire’s.
“You were very lucky,” said Carol Tracy, a psychologist who has treated only outpatients, about my long-term care as an inpatient. While outpatients usually are able to make the connection between their eating disorders and how they use that to cope with other issues, those that into outpatient treatment too soon because of insurance issues may need additional treatment they’re not getting.
Amanda’s mom Stella said her insurance picked up 80 percent of the combined three months’ hospitalization, and Stella, who wanted her last name omitted for this post, said she was liable for the other 20.
“I don't remember the amount of the bill for each hospital, but, as you can imagine 20 percent of a three month stay in the hospital was sizeable,” Stella wrote in an e-mail.
She remembers paying thousands of dollars to St. Claire’s but was able to negotiate through her insurance company payment for the Westchester hospital Amanda stayed at following St. Claire’s.
“Remembering the paperwork that I received, it seems that if you don't have insurance, you owe the hospital considerably more than if you do,” Stella wrote. She said the hospital charges a certain amount per day (say $100), and the insurance company could negotiate it down to $80, reducing the overall size of the bill by 20 percent, and reducing the bill that a parent or patient ultimately pays.
“If you have no insurance, there is no one who will negotiate a more reasonable price for you. In other words, the people least able to pay, the uninsured, have the highest liability,” Stella wrote.
An October 2007 edition of Newsweek features Dawn and Bart Beye, a New Jersey family suing their insurance company because their anorexic teen daughter would not be covered after three weeks of treatment.
In their class-action suit, filed against Horizon Blue Cross on behalf of the residents of New Jersey, New York and Pennsylvania, the Beyes argue their daughter and others suffering from eating disorders have illnesses that are “biologically based” and “should be covered under the laws of all three states,” Newsweek reported.
Not so, says the insurance company disagrees, arguing that anorexia is not a result of genes but rather the environment and should not be covered by state laws.
The National Eating Disorders Association estimates about 11 million people in the U.S. are affected by eating disorders, but “only 11 states have laws explicitly mandating that insurers cover their treatment. Thirty-four states require general mental health coverage, though insurance companies have a lot of leeway in how they define ‘mental disorders’ and some may not cover anorexia or bulimia,” according to the Newsweek article.
