Should insurers cover eating disorder treatment?

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There's a rising call for insurers to boost their coverage of eating disorders, including anorexia and bulimia, as lobbying groups work to raise awareness and potentially mandate such coverage.

"Despite being biologically based mental illnesses with potentially severe physical health ramifications, including death, eating disorders are all too often found on lists of benefit exclusions," the Eating Disorders Coalition wrote to federal officials in a letter this year. The lobbying group says eating disorders affect 14 million people, many of whom face gaps in care because they lack full insurance coverage for needed treatments.

The problem with covering eating disorder treatments, insurers say, is there's no universally recommended care plan for treating anorexia and bulimia, reported Kaiser Health News. That's because "there's a lack of evidence for what works and what doesn't work," according to Susan Pisano, a spokeswoman for America's Health Insurance Plans.

"Any eating disorder is a complex condition," Diane Robertson, director of the research consultant company ECRI Institute, told KHN, adding that researchers analyzing eating disorders "haven't done a good job in doing outcomes research and finding what combination of treatments work."

Indeed, mental health experts agree there's no one-size-fits-all treatment plan for eating disorders. Treatment, which is "often tailored to individual needs," can include antidepressants, group counseling sessions, individual therapy and nutrition consultations, says Mark Chavez, an associate director at the National Institute of Mental Health's Research Training and Career Development Program.

Before approving coverage for any medical treatment, insurers typically require rigorous evidence of that treatment's effectiveness. But patients and advocacy groups increasingly have launched campaigns--one of which resulted in 31 states mandating coverage of an autism treatment once considered too experimental--to force insurers into enhancing coverage of certain treatments. UnitedHealth and Blue Shield of California, for example, now provide coverage for applied behavior analysis to treat autism, FierceHealthPayer previously reported.

To learn more:
- read the Kaiser Health News article

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