Using Aetna for Eating Disorder Treatment

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With over 22 million members, Aetna is one of the largest health insurance providers in the United States. It offers many different health insurance plans, primarily through employers. If you are considering getting treatment for an eating disorder, the following guide will help you navigate the complexities of using Aetna for eating disorder treatment.

There are several different types of eating disorders, including anorexia nervosa, bulimia nervosa and binge eating disorder, but they are all characterized by an obsession with food, weight and appearance. Someone with an eating disorder may experience any or all of the following symptoms:

• Refusal to eat or eating to the point of discomfort or pain
• Negative or distorted self-image
• Excessive exercise
• Preoccupation with food
• Social withdrawal
• Dehydration
• Irregular heart rhythms
• Extreme weight loss

Statistics show that 95 percent of those with an eating disorder fall between the ages of 12 and 25, which means many of them are adolescents who are still living at home. If you are concerned that one of your children or another loved one is struggling with an eating disorder, here are some red flags to look out for:

• Skipping meals or adopting food rituals at mealtimes, such as cutting food up into small pieces or only eating very specific foods
• Persistent worries related to body image and appearance
• Not wanting to eat in public
• Food hoarding or eating in secret
• Withdrawing from social activities
• Having a distorted body image or making constant complaints about weight
• Making excuses for not eating

Remember that the earlier you get treatment, the better your prospects for recovery, so if you are concerned that you or a loved one may have an eating disorder, call us at as soon as possible. Our friendly representatives are standing by to take your call.

Using Aetna for Eating Disorder Treatment

When you are using Aetna for eating disorder treatment, you do not need to get a referral from your primary care physician, but you do need to find a provider in the Aetna network. Call the behavioral health number on the back of your insurance ID card, and a clinical care manager will assess your current situation and help you find a qualifying provider.

Individual plans will vary in regards to specific coverage, limits and expected out-of-pocket expenses, so be sure you have a good understanding of what your plan covers before embarking on a course of treatment. In general, Aetna insurance coverage plans may fully or partially cover inpatient services, including counseling and therapeutic services, in a hospital or residential facility, and short-term evaluations and interventions on an outpatient basis. Each of these services is subject to limits, so check your individual plan for specific information.

If you are in an emergency situation, you should call your primary care physician if possible. Otherwise, your doctor should be notified as soon as possible and coordinate all follow-up care. Be aware that the plan does not cover nonemergency use of the emergency room.

Will Aetna Cover Eating Disorder Treatment?

Aetna will cover all treatments that are medically necessary, but your plan may not cover the entire length of treatment that is recommended. Managing an eating disorder is often a long-term and intensive process that involves a multidisciplinary team of medical professionals. Usually, a medical doctor, psychologist, psychiatrist and nutritionist are needed. Each patient needs a treatment plan that is tailored to his specific needs and situation. Some of the common components of an eating disorder treatment include:

• Counseling or psychotherapy. This is the most important component of eating disorder treatment. Through therapy, the patient will learn to have a healthy relationship with food and develop new strategies for coping with the stress of everyday life. Continuing therapy is key to maintaining healthy eating habits and having a realistic and positive body image.
• Medication. Although no medication can cure an eating disorder, medications can be valuable in controlling urges and anxiety and treating coexisting conditions that may exacerbate or trigger the eating disorder.
• Medically supervised weight restoration. Patients with an eating disorder are often significantly underweight or overweight. This can cause dangerous and sometimes life-threatening damage to the body. The first goal of treatment is usually to get the patient to a healthy weight.
• Nutritional education. Nutritional counseling is paramount in the long-term management of an eating disorder. Those suffering from an eating disorder have an unhealthy relationship with food and need to learn or relearn how to plan a healthy diet.
• Support groups. Support groups are a valuable way to connect with people going through a similar struggle. Eating disorders sometimes need lifelong maintenance, and support groups can be key to staying in recovery.

How Much Will Eating Disorder Treatment Cost?

The cost of eating disorder treatment depends on a number of factors. Inpatient treatment can range anywhere from $500 to $2,000 a day, and the average cost for a 30-day stay in a treatment facility is $30,000. Patients often need from three to six months of inpatient care. Outpatient care, including medical monitoring and continuing therapy, can reach upwards of $100,000. The cost of any patient’s treatment can vary widely from these figures, depending on the severity and duration of the eating disorder. Be sure that you are clear on what your insurance will cover before deciding on any course of treatment.

You may have to make an expected out-of-pocket contribution even if your Aetna plan covers treatment. Be sure to check your specific plan to find information regarding copays and deductibles that you may be responsible for. For help finding treatment for an eating disorder, call us at today. We are available 24/7 to help you seek treatment.

Inpatient Eating Disorder Treatment vs. Outpatient Services

When you’re crafting your treatment plan, the general goal is to find the duration and intensity of services that are appropriate for your situation. Inpatient treatment involves a patient receiving 24-hour care in a residential facility. This can be valuable in the treatment of an eating disorder because the patient will receive constant medical monitoring. The patient is provided therapy and medication in a very structured setting. This type of treatment is often used for severe eating disorders. Inpatient treatment allows patients to avoid the stresses of everyday life and fully focus on their recovery.

Outpatient treatment is more flexible and may be attractive to those with responsibilities related to children, work or school. Therapy and medical attention are provided several times a week, with the patient going home in between sessions. These programs can vary in frequency and duration based on the patient’s needs.

When a patient with an eating disorder first seeks treatment, a stay in a hospital is sometimes needed. Eating disorders can cause dangerous and life-threatening damage to the body, including dehydration, electrolyte imbalances, kidney and cardiac damage, and irregular heart rhythms. These issue need to be resolved before any further progress on the eating disorder can be made.

Dual Diagnosis Eating Disorder Therapy

Eating disorders are often accompanied by one or more coexisting disorders. Although it is sometimes difficult to determine whether the other disorders were causes or effects of the eating disorder, it is imperative that they be treated at the same time as the eating disorder. An untreated mental disorder can be a huge obstacle to staying in recovery long-term. Some of the most common conditions seen alongside an eating disorder are as follows:

• Obsessive-compulsive disorder. OCD is an anxiety disorder that is characterized by feelings of anxiety that cause sufferers to have reoccurring and obsessive thoughts and drive them to perform repeated and compulsive actions. Many of those struggling with an eating disorder have such thoughts and actions related to food, so these conditions can be strongly linked.
• Other anxiety disorders. These can include generalized anxiety disorder, PTSD and social anxiety disorder. The patient may develop an eating disorder in an attempt to control the symptoms of any of these.
• Depression. Depression can stem from abnormal brain chemistry or an event in the patient’s life. The symptoms of depression can exacerbate or trigger the symptoms of an eating disorder.
• Substance abuse. When a patient is struggling with an eating disorder, he/she may turn to drug or alcohol use as a coping mechanism. It is imperative that these issues are dealt with during the course of treatment.

If you or a loved one is struggling with an eating disorder or any of the aforementioned issues, call us at . Our representatives are available 24/7 to help you get started on the road to a healthier life.

Insurance vs. Private Pay for Eating Disorder Options

When you are deciding on a course of treatment, it is important to have an idea of how much your insurance will cover and how much you are able to pay. Some patients choose to privately pay for their treatment because of concerns about privacy or the desire to use an upscale facility that their insurance won’t cover. If you have the means to pay for treatment, you have many options. Some facilities offer luxury accommodations, alternative treatments, longer stays and almost any amenity that you can think of.

If you don’t have the means to pay, you still have some financing options. Contact your treatment facility, as some facilities may offer programs that charge on a sliding scale based on income. Other facilities may offer scholarships for needy families or financial aid to apply towards treatment. Many facilities offer payment plans that will spread the cost of treatment over a more manageable timeframe. You may need to be persistent, but help in financing treatment is available.

A study has shown that about 80 percent of girls and women who receive care for eating disorder do not get the intensity of treatment that they need. They are sent home weeks earlier than recommended, which affects the time they stay in recovery. Make sure you are getting the care you need. An eating disorder can feel overwhelming, but help is available.

If you or a loved one would like assistance in navigating your Aetna insurance policy and exploring treatment options, call us today at . It is not too late to turn your life around. Eating disorders that are addressed early have a much better outlook for successful treatment than those addressed later.