Using AmeriHealth for Eating Disorder Treatment

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Founded in 1995, AmeriHealth provides medical coverage to over 200,000 people across New Jersey. Like other insurance carriers, AmeriHealth requires certain criteria before it will provide insurance for behavioral health treatment, including bulimia and anorexia. Eating disorders have the highest mortality rate of any other mental illness. This is why it is extremely important to seek help immediately.

According to the South Carolina Department of Mental Health, approximately 8 million people currently suffer from eating disorders in the United States, and AmeriHealth’s goal is to ensure you get the care and assistance you need to get well. If you or someone you love is suffering from an eating disorder, contact us at to discover your options.

Using AmeriHealth for Eating Disorder Treatment

Not only does AmeriHealth Insurance coverage help you pay for your eating disorder treatment, the company can assign a specialty case management team that will work closely with you and your family to offer the support you need during treatment. AmeriHealth’s team consists of licensed professionals who have specialized training in eating disorders. From the minute you contact AmeriHealth, you are assigned a case manager who will help walk you through the process of getting the most from your benefits. You can also look through a copy of your plan details if you have questions about what it covered.

Will AmeriHealth Cover Eating Disorder Treatment?

Many insurance companies refuse to pay for mental health treatment because it can be so tricky to diagnose. Fortunately, AmeriHealth is dedicated to providing coverage for a variety of behavioral health services, and if you carry an AmeriHealth policy that will cover the cost of eating disorder treatment, the payment for treatment will generally work the same way as your medical coverage.

Before you consider finding help in treating eating disorder, you should contact your AmeriHealth representative. The phone number can be found on the back of your AmeriHealth identification card, and it is a good idea to have the social security number of the person insured with you when you make the call. This can make it easier to locate your policy. Even if your policy covers eating disorder treatment, the insurance reimbursement rate differs from that of medical treatment.

In most cases, it’s best to be seen by an in-network physician or your primary care physician first, because you may need to provide AmeriHealth with any clinical findings before it will determine if you require further treatment. Your doctor can refer you to a mental health specialist who will take your insurance, because chances are, if your doctor is an in-network physician, he/she will know who to direct you to. Keep in mind, if you choose an in-network physician, you are guaranteed the best treatment from a licensed professional who meets AmeriHealth’s strict care guidelines.

If you choose an in-network mental health physician, you will be required to pay your copay for the visit. Usually this runs between $20 and $40, depending on the specifics outlined in your policy. If the physician is out of network, you will be required to pay the entire cost of the visit when services are rendered and AmeriHealth will pay back a percentage of the cost. Depending on your policy, AmeriHealth may also pay only a certain number of visits whether the doctor is in-network or not, so it’s important to check your policy details before you schedule treatment.

Not all services will need to be preauthorized. A visit to an in-network psychiatrist or any treatment used to stabilize you may not be. If you have questions concerning eating disorder treatment, contact us at for answers.

How Much Will Eating Disorder Treatment Cost?

The cost of treating an eating disorder can vary from person to person depending on the severity of the condition. According to the New York Times, the cost of a residential program for an eating disorder can be as much as $30,000 a month. Some patients require several months of treatment, and some even need years of follow-up treatment. This can total over $100,000 from the time of initial diagnosis until the individual can live independently.

If you opt for outpatient services, which include the cost of medical monitoring and therapy, the cost can still run from $500 to $2,000 every day. Sadly, because of the cost of treatment, only one in 10 people will receive treatment. Studies have shown that with early intervention, the prognosis for a full recovery is good.

Treatment plans often include one or more of the following options:

• Group therapy
• Individual therapy
• Family intervention
• Medical care and health monitoring
• Nutrition advice
• Prescription medications
• Hospitalization

For eating disorder treatment to be successful, it must first address the physical weight issue. The person must be restored to a healthy weight range, the psychological issues that caused the eating disorder must be addressed, and treatment must work towards reducing the behaviors and thoughts that led to the illness. Even after all the medical and psychological reasons for your eating disorder have been addressed, you must still look to long-term care to prevent relapse. Because this can be a lifelong process, many insurance companies will not cover long-term care. The length of time your AmeriHealth policy will cover can be discussed with your insurance representative.

Inpatient Eating Disorder Treatment vs. Outpatient Services

Inpatient eating disorder treatment will provide you with 24-hour care in a monitored medical facility. This assistance is provided from the time you check in until the time you leave. Inpatient treatment programs are often preferred for someone suffering from an additional condition, such as alcohol or drug addiction. The treatment center can help the person get through detox, and a local hospital can also provide treatment if necessary. Inpatient treatment allows you to spend time with others who are going through the same issues that you are.

Outpatient programs are ideal for executives and students who cannot be away from school or life responsibilities for too long. This type of treatment is recommended for those who have mild symptoms or for someone who has been diagnosed early on in the illness. You receive the same type of care during the day in an outpatient facility that you would in an inpatient one, with the biggest different being you return home each night. Outpatient programs still allow patients to meet in a group setting several times per week for a few hours at a time. This type of treatment is also cost-effective. One simple form of outpatient treatment might consist of meeting with a therapist a few days each week to discuss triggers or behavioral issues.

Some of the main things to consider when deciding between inpatient and outpatient care are:

• The cost of treatment and how much your AmeriHealth plan covers
• Self-control
• Follow-up care
• Severity of the condition
• Distance from home

Dual-Diagnosis Eating Disorder Therapy

It is not uncommon for those suffering from an eating disorder to have an underlying addiction or another illness, such as depression. According to Vanderbilt University, the presence of an eating disorder can increase your chances for another disorder such as alcohol or drug addiction by as much as 50 percent. While the reasons behind this are unknown, it is thought that someone who suffers from poor body image may resort to binge drinking, illicit drug use or other addictions to help cope with painful feelings. Some stimulants, such as cocaine and meth, may be used to promote weight loss.

The demographics for those suffering from a dual diagnosis with an eating disorder vary, but studies have shown that over 90 percent are female. Anorexia is one of the leading causes of death among women and young girls, especially those who never seek help. The illness itself can cause dehydration, low blood pressure and chronic health problems. When this is combined with alcohol and drug addiction, the results are often fatal. If you have questions concerning a dual diagnosis or addiction treatment, contact us at and we can answer any questions you may have.

Many insurance companies may provide coverage for the alcohol and drug addiction treatment but not pay for the eating disorder treatment. This can often be counterproductive, because once the addiction treatment is over the person may resort back to damaging eating habits, which can lead to a relapse. This is why it is extremely important to receive treatment for all issues.

Insurance vs. Private Pay for Eating Disorder Options

One problem with an eating disorder treatment is that if you do not have the insurance coverage to cover the costs, you may not receive the care you need to completely recover from the illness. While having an AmeriHealth policy that will cover the cost of your treatment can be helpful, it does not mean you cannot receive care if you don’t have such a policy. Without coverage, your choices may be limited in regard to whom you can see or how much treatment you will be able to afford. If you are a teenager on your parent’s policy, your parent will receive a statement of charges even if the policy covers all the costs.

Other options for treatment include:

• Community-based programs
• School resources
• Self-help groups
• Church groups
• Helplines

Check with your primary care physician, or search online, to see if there are any local free clinics. Volunteers within in the medical community often run free clinics, and you may have to meet income requirements in order to get an appointment. It may also take a long time to get an appointment because the waiting lists for free treatment can be long.

If you attend college, you may be able to seek counseling on campus. Most colleges include the cost of counseling in your tuition, so you can receive treatment free of charge. Also, if you meet certain income requirements, you may be able to apply for public assistance, including Medicaid, through your county’s health department.

Paying for the treatment yourself is doable if you talk to the treatment center beforehand. Even if you find out your AmeriHealth policy won’t pay, many centers will allow you to set up payment arrangements or finance your treatment. If you or someone you love is looking for eating disorder treatment, contact us at to discuss your options.