Making Your Way Through the Health Insurance Maze, Part 2

Making Your Way Through the Health Insurance Maze, Part 2

In case you missed part 1, click here.

When it seems that all has failed, and your benefits are not attainable, or if you have no money or other insurance, creative approaches can work. Above all, don’t give up—here are some more strategies.

Try creative approaches

Some families have finally gotten help by contacting their attorney when benefits are apparently available through an insurance company but the benefits are not being provided. Other families have gotten results by contacting their local media and describing their plight.

Can you afford care if your insurance company won’t pay for it?

Once you know what care is recommended, who should provide it, and where it should be provided, find out the stated total charges from the treatment center and/or professionals providing the care. Assess your own financial resources. Try to negotiate a fee/ charge you can afford.

If you have Medicare or Medicaid benefits

Although many hospitals and treatment centers accept Medicare and/or Medicaid, many have no staff members with experience in treating eating disorders. If the treatment center is a mental health center, which is funded in part by county, state, or federal funds, they may be required to make appropriate care available.

When you have no money or insurance benefits

Programs designed for people with no money or insurance benefits are often hard to find. Some agencies that receive public funds do provide treatment, and sometimes that treatment is outstanding. Another way to get treatment is through community agencies—sometimes treatment is provided at no cost or on a sliding scale fee.

If you are a student, check your campus counseling centers and student health services.

To get treatment at these centers, a student health fee is usually paid along with your tuition. Also, many psychiatry departments within medical schools have low-fee clinics run by psychiatric residents (medical school graduates with 2-3 years of psychiatric training, who are supervised by experienced faculty members).

If this type of care is available at your school, ask if they have low-fee clinics run by residents and if they will accept a patient with an eating disorder. Be sure to ask about sliding- scale fees and about what supervision the medical resident has available to him or her.

Sometimes treatment studies provide free treatment to test the effectiveness of new drugs. Participants may receive the drug or a placebo, but in either case they also receive more comprehensive treatment (for example, group therapy sessions).

No-fee research treatments.

Some universities have research programs that also offer treatment. For example, from time to time Columbia University has openings for anorexia nervosa patients willing to be part of an ongoing research program. The program is at the Eating Disorders Clinic at New York State Psychiatric Institute, at Columbia Presbyterian Medical Center. For information, call the research assistant at: (212)543-5739

Above all, don’t give up!

Keep trying to get better and trying to locate people to help you. Although there can be many barriers to accessing appropriate professional treatment, your commitment to recovery will make a big difference. Care providers themselves are energized when patients want to recover and can often help you find the treatment you need. Many primary care physicians and pediatricians are relentless in trying to find programs for their patients and your interest in recovery will encourage them to assist you.

Reprinted with permission from Eating Disorders Today 
Summer Volume 1, Number 2 
©2002 Gürze Books

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