Eating Disorders: Families Fight Insurance Cos.

I normally try to keep this blog focused specifically on drug and alcohol addiction, but this story so vividly illustrates the need for parity that I wanted to share it. Here are the key points, but take the time to read the whole thing.

Though eating disorders affect some 11 million people in the United States, according to the National Eating Disorders Association, only 11 states have laws explicitly mandating that insurers cover their treatment. Thirty-four states require general mental health coverage, though insurance companies have a lot of leeway in how they define "mental disorders” and some may not cover anorexia or bulimia. The result is many families sinking into medical debt. “Wherever I go, I hear the same stories—families depleting their retirement accounts, going through life savings, taking second mortgages on their homes because insurance companies won’t pay for their child’s coverage,” says Lynn Grefe, head of the National Eating Disorders Association, a Seattle-based advocacy group. “I don’t think I can think of a state where I don’t hear these stories, and families just don’t know how to get out of this hole.”

That denial of coverage is why Dawn Beye, with the help of a vast team of medical and legal experts, filed a class-action lawsuit Nov. 8 against Horizon Blue Cross on behalf of the residents of New Jersey, New York and Pennsylvania—maintaining that her daughter’s and other similarly situated patients' illnesses are “biologically based” and should be covered under the laws of all three states. The company disagrees, saying anorexia is a product of one’s environment rather than genes—and therefore not covered by the state laws. At stake, says Beye, are lives—as more than 10 percent of the nation’s 8 million anorexics will die from their disease, according to the National Eating Disorder Association.