BY: Lauren Metzger, MSW
DATE: July 16, 2015
In 2014, The Affordable Care Act (ACA) expanded mental health and substance abuse treatment for over 62 million Americans by requiring insurance companies to pay for mental health and substance abuse treatment at the same level as physical health services. This was welcome news for people who struggle with paying for treatment not covered by their insurance, including those who seek individual outpatient therapy for eating disorders.
Although mental health parity laws have helped close the gap between coverage for psychological and physical health conditions, states still have vague laws around eating disorder treatment. Now, good news is coming from the state of Missouri for eating disorder treatment and insurance coverage! Missouri has become the first state to accomplish clear guidelines for what health insurance companies must cover for eating disorders. The new Missouri law gives specific information about what will be “medically necessary” for both the physical and psychological treatment of eating disorders and requires that health insurers must consider the overall medical and mental health needs of an individual with an eating disorder when making coverage decisions.
Eating disorders treatment is expensive, especially if inpatient, residential, or partial hospitalization treatment is required. Insurance coverage is essential; however, treatment is frequently cut short when insurance companies deem patients sufficiently healthy for discharge despite provider recommendations. Many patients and families cannot afford to continue treatment paying out of pocket. Far too frequently, decisions are based solely on BMI, failing to recognize other physical and psychological factors that warrant further treatment to ensure recovery.
The Missouri law is a resounding success for eating disorders advocates, and should help pave the way for future change! To find out more, visit the Missouri state website.