Using GEHA Health Plans for Eating Disorder Treatment

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Government Employees Health Association is the second-largest health and dental plan in the country serving federal retirees, federal employees and their families. It offers dental and health plans to over 1 million members worldwide.

GEHA Health Plans is a nonprofit and self-insured organization that doesn’t require its members to pay any dues. Currently, it waives all membership fees. Out of every dollar it receives, 94 cents goes directly to the health benefits of members.

All annuitants and federal employees who are qualified to join the Federal Employees Health Benefits program are entitled to become members of the Government Employees Health Association Inc. To enroll, just complete the Standard Form 2809 or the Health Benefits Registration Form.

If you have limited resources and income, you can get outside assistance in paying for your Medicare prescription drug plan. More details concerning this program are obtainable through the Social Security Administration. To learn more about this program, you may visit the organization’s website or call our helpline at .

Will GEHA Health Plans Cover Eating Disorder Treatment?

GEHA Health Plans covers treatment for eating disorders under section 5(e) of the GEHA Benefit Plan brochure titled Mental Health and Substance Abuse Benefits. According to the mental health charity organization Mind, eating disorders are one of the most common types of mental health problems.

According to section 5(e), you can get treatment for your eating disorder either from GEHA Health Plans network or outside of it. However, you must first secure approval for inpatient residential, inpatient hospital and intensive day treatment services. Limitations and cost sharing for substance abuse and mental health benefits should not be greater than those for other conditions and illnesses.

Some of the most important things to bear in mind concerning these benefits include:

• All benefits are subject to the limitations, definitions and exclusions specified in the GEHA Health Plan brochure and are paid for only after the network determines the necessity of the medical services.
• The yearly deductible for self-only enrollment is $1,500, and the deductible for self and family enrollment is $3,000. These deductibles can be fulfilled by one or more members of the family and apply to all benefits in section 5(e).
• Your coverage starts only after you have fulfilled your deductible.
• Under the traditional medical coverage, you must shoulder the coinsurance amounts for qualified prescriptions and medical expenses.

These are just some of the provisions contained in section 5(e) of the GEHA Benefit Plan brochure. To find out the full extent of your benefits from this plan, give us a call at .

How Much Will Eating Disorder Treatment Cost?

Eating disorders can be very expensive to treat because care must be provided by a team of health care professionals, including a nutritionist, psychiatrist and doctor, on a weekly basis. On average, treatment for an eating disorder at an inpatient facility costs about $30,000 per month, according to The New York Times.

For some patients, treatment could last for three months or longer to allow for complete recovery, and this care is normally delivered in a facility that is away from home. After you leave the facility, you will begin follow-up care, which could take several years to complete.

When you are ready to begin treatment for your eating disorder, contact a representative of GEHA Health Plans to learn more about the costs. For help with the process, you can talk to one of our dedicated staff members at . All you need to do is pick up the phone and call us.

Inpatient Eating Disorder Treatment vs. Outpatient Services

Inpatient eating disorder treatment calls for 24-hour care and residence in a treatment facility for a period of time. You will be given constant medical supervision to keep an eye on your progress. Inpatient care is structured, so you can focus on your psychological and physical healing. Everything you need will be provided in one place.

Inpatient treatment is ideal for patients with progressive eating disorders, which require psychiatric and medical stabilization. A treatment counselor will evaluate your conditions, and then a case manager will be assigned to monitor you. Your eating patterns will be monitored continuously, and a treatment plan will be developed to address your specific needs. This plan usually includes behavioral therapy, medication, psychotherapy and nutritional counseling.

Residential care follows after the case manager determines that you are ready to live on your own. You will be placed in an environment that resembles a home to let you practice the coping skills you learn during therapy. Even so, this part of your treatment will follow a program and be monitored by clinicians. This will keep your progress in check and help you handle triggers that might lead to relapse.

Compared to inpatient treatment, outpatient care is less restrictive. Your responsibilities might include seeing a therapist, nutritionist and other health care providers three or four times a week. This type of care may be suitable for patients who cannot leave their responsibilities at school or work behind. This is also a good option for patients who don’t have sufficient insurance to cover executive or luxury treatment. Treatment methodologies usually include personalized nutrition counseling, individualized therapy, family support groups and topic-focused groups.

When you have gone through the rigorous treatment in an inpatient setting and have shown enough signs of recovery that you are deemed capable of living independently, you will move on to outpatient care. You will be allowed to return to your home and perform your duties at work or school. However, you will continue to receive psychotherapy and support from your eating disorder facility as well as structured meals, relapse prevention planning and ongoing guidance about coping techniques.

After you have made your choice concerning inpatient eating disorder treatment vs. outpatient services, it is time to find help in treating eating disorder problems. If you don’t have the time to search for one yourself, let our friendly advisors at do the job for you. Call to speak to one of our staff members at any time.

Dual Diagnosis Eating Disorder Therapy

The prevalence of drug or alcohol abuse in people with eating disorders is about 50 percent compared to 9 percent of the general population, according to the National Institutes of Health. A dual diagnosis is best treated in an inpatient setting by professionals who have the expertise to deal with co-occurring disorders such as substance abuse and eating problems.

Inpatient treatment allows you to be monitored by your physicians all day long, so any problem that may arise will be held in check. This is ideal for patients with eating problems because the staff will be able to regulate what and when you eat as well as control the adverse effects connected to withdrawal symptoms.

Therapy for a dual diagnosis usually begins with detox to rid the body of the addictive substance. After this, you will work closely with a therapist. Your treatment may include group therapy, cognitive behavioral therapy and talk therapy. Cognitive behavioral therapy trains you to respond well to anxiety or stress in various ways, making you better equipped to avoid improper eating habits.

Eating disorder recovery programs focus on helping you develop a healthy physical condition and put on weight. This can alleviate several potential side effects related to your withdrawal symptoms, such as tiredness and dizziness. Medications may also be administered to treat depression or anxiety.

If you find it hard to determine whether you or someone close to you has co-occurring health problems such as an eating disorder and substance abuse, help is available. You can speak to one of our dedicated advisors at .

Insurance vs. Private Pay for Eating Disorder Options

Treatment for eating disorders can take years to complete, and this can affect not only your personal relationships and health but also your finances. According to the federal Agency for Healthcare Research and Quality, hospital visits as a result of eating disorders increased by 18 percent from 1999 to 2006. What makes the situation worse is that many insurers deny coverage for lengthy eating disorder treatment. Insurance providers rebuff sufficient coverage because treating an eating disorder is very challenging compared to treating other types of psychiatric problems. In addition, an eating disorder is often more difficult to diagnose.

To obtain guidance about insurance matters, you can visit the website of the National Eating Disorders Association. There, you will learn how to persuade your insurer to cover your eating disorder treatment, how to write letters you can send to hesitant insurers, and how to handle an appeal.

If your insurer denies your request for coverage, you can at least ask to be assigned a case manager. This go-to person can often assist you in obtaining supplementary care. Insurance providers typically do not pay for nutritional counseling, though there are exceptions.

If your case manager cannot give the necessary aid, you can try asking your employer’s human resources department to request aid from your insurer on your behalf. If this move fails, this is the time to submit a formal appeal to your insurance provider. If your appeal is ignored or you don’t receive an answer, you may contact your representative in Congress or the insurance commissioner of your state.

If one of your children is diagnosed with an eating disorder, such as anorexia or bulimia nervosa, family-based therapy is a good alternative. This type of treatment is relatively inexpensive because the patient’s family handles the monitoring. With the assistance of a therapist, you can take full responsibility for getting your child back to normal eating habits and a healthy weight.

Even though this type of care can save you a lot of money when compared to inpatient treatment, your family might have to bear the emotional strain involved in having to treat a family member. During the initial stages of treatment, which can span several months, you need to supervise your child 24 hours a day, provide snacks and meals, and lead all necessary exercise.

To find out more concerning insurance vs. private pay for eating disorder options, call our helpline at . Our devoted staff members will answer your call any time of the day or night.