Using Aetna for Bulimia Treatment

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People with eating disorders are abnormally concerned with maintaining a particular weight or body shape and, as a result, develop abnormal eating habits that affect their health and well-being. Bulimia nervosa is a type of eating disorder characterized by eating large amounts of food in a short period of time and then eliminating the food from the body to avoid weight gain. This cycle is commonly called binging and purging.

Bulimia nervosa patients attempt to purge the food they have eaten by making themselves throw up or by taking laxatives to speed up the natural movement of food through the body. Some bulimics use excessive exercise to try to rid themselves of calories or follow strict diets outside of the binge-and-purge cycle.

According to the National Eating Disorders Association (NEDA), 80 percent of bulimia nervosa sufferers are female, and the disease affects 1 to 2 percent of all adolescent and young adult women. Although bulimia affects primarily young women, men and women from all age groups suffer from this eating disorder. If you or your loved one suffers from bulimia nervosa, it is never too late to seek help. Please call . We’re available 24/7 to take your call.

The binge-and-purge cycle of bulimia can be extremely harmful to the body, resulting in serious health issues that sometimes lead to death. The Office of Women’s Health of US Department of Health and Human Services lists many physical effects of bulimia nervosa, including:

• Erosion of tooth enamel
• Gum disease
• Stomach ulcers
• Irregular or absent periods in women
• Irregular heartbeat
• Low blood pressure
• Low pulse

People with bulimia nervosa may also suffer from mental health issues in addition to the physical effects of the disease. Bulimics are often depressed and can suffer from anxiety, mood disorders, substance abuse or self-mutilation. Since bulimia affects individuals both physically and mentally, it is important for health care professionals to address all issues resulting from the patient’s bulimia in order to give the best care.

Treatment for bulimia nervosa is often provided by a team of health care professionals, including doctors, nutritionists and behavioral therapists. Treatment is usually provided on an outpatient basis, but inpatient treatment may be necessary for severe cases or if outpatient treatment has been ineffective in the past.

When you’re ready to explore Aetna insurance coverage for bulimia treatment, call the number on the back of your insurance card for detailed insurance information. Bulimia nervosa is a complex issue that can sometimes make it difficult to accurately determine coverage. The most effective way to use your Aetna insurance for bulimia treatment is to closely coordinate with Aetna before seeking treatment.

Does Aetna Cover Bulimia Nervosa Rehab Programs?

Aetna offers many unique insurance plans to employers and individuals in several states. Coverage varies depending on your particular plan. Some plans do not offer mental health benefits and are less likely to cover inpatient treatment. Aetna’s coverage for bulimia nervosa treatment sometimes addresses physical medical care separately from the behavioral treatment, so it is possible that certain treatments within a rehab program will be covered while others will not.

Aetna’s Clinical Policy Bulletin notes that patients must meet certain selection criteria before receiving services for bulimia. Aetna’s clinical policy considers the following treatments medically necessary for the management of bulimia nervosa:

• Blood count and serum chemistry
• Electrocardiography
• Liver function tests
• Medical evaluation, including complete medical history and physical examination
• Psychiatric/psychological consultation and testing
• Urinalysis
• Nutritional counseling
• Medication therapy
• Psychotherapy, including cognitive behavioral therapy, family psychotherapy, interpersonal psychotherapy and psychodynamic psychotherapy

Plan copays and deductibles are the patient’s responsibility, regardless of the type of care being sought. Call the number on the back of your insurance card to find out if your plan covers bulimia rehab programs.

Inpatient Treatment Length Aetna Will Cover (28-30, 60, 90+ Day)

Inpatient treatment for bulimia nervosa can last days, weeks or even months. Inpatient treatment is usually recommended for patients who are medically unstable with fluctuating vital signs, acute health risks or complications due to other coexisting medical problems. These patients may be referred to inpatient facilities that offer 24-hour focused care and monitoring within a structured environment.

The level of treatment Aetna will cover depends on your plan and your behavioral health coverage. Contact Aetna directly for specific information regarding your plan. If you are unsure of how to approach treatment for bulimia nervosa, don’t hesitate to call us at . We’re here to help.

Aetna Coverage for Bulimia Dual Diagnosis

Determining insurance coverage for bulimia nervosa can be particularly difficult because many patients have more than one diagnosis, encompassing medical and behavioral health issues. Once a patient meets the clinical criteria for bulimia nervosa, Aetna will cover treatment for issues related to bulimia in accordance with the clinical policy bulletin and the patient’s individual plan coverage. If there is a coexisting diagnosis that is not related to bulimia, that medical problem is covered as a separate issue. The Bulimia Nervosa Resource Guide advises patients that “depending on the case severity, Aetna may assign a case manager to coordinate medical and behavioral health services by all providers involved in the care of the patient.” For more information about using Aetna for eating disorder treatment, call us now.

Specialty Bulimia Treatment Treatments Using Aetna

Although Aetna allows for coverage of a wide variety of treatments for bulimia nervosa, some specialty treatments are not covered. Aetna’s Clinical Policy Bulletin states that some treatments are considered experimental because there is not sufficient evidence in peer-reviewed literature of their effectiveness. These experimental treatments include:

• Brain imaging
• Campral for the treatment of binge eating disorder
• Bupropion (Zyban), lithium, and naltrexone for the treatment of bulimia nervosa
• Cholinesterase inhibitors (e.g., donepezil) for the treatment of anorexia
• Deep-brain stimulation (treatment-refractory anorexia)
• Oral contraceptives in preventing bone loss in patients who have stopped menstruating due to an eating disorder
• Repetitive transcranial magnetic stimulation
• The Mandometer treatment

Check your plan information or call the number on the back of your insurance card to be sure that your recommended treatment will be covered. To know more about your eating disorder treatment program options, call our helpline today for more information.

How to Cover What Insurance Doesn’t Pay For

Treatment for bulimia nervosa can be very expensive due to the intensity and length of treatment required. Advocacy groups like NEDA offer information on how to get insurance to cover treatment for eating disorders, even if your claim has been denied. However, even with comprehensive coverage and help with maximizing your benefits, it is possible for some portion of treatment to remain uncovered.

Most treatment centers offer payment plans to patients who must cover part of their care expenses on their own. Some academic hospitals offer free treatment to patients willing to participate in research trials. Traditional financing or bank loans can also be used to pay for treatment. It is important to remember that treatment is crucial for recovery from bulimia.

Verify Insurance Coverage and Find the Best Treatment Centers

Advocacy websites such as the Bulimia Nervosa Resource Guide are logical places to begin when looking for information about insurance coverage, treatment programs and other resources. You can find information about how to choose a treatment center and, sometimes, reviews from patients regarding local facilities. Make sure that you get the most out of Aetna insurance benefits by verifying coverage before beginning treatment. Aetna’s website has links for current members to check coverage as well as lists of approved facilities and links to clinical policy bulletins for further information.

Beginning treatment for an eating disorder can be intimidating, but taking action is an important first step. Call us at for help.