Insurance and Eating Disorders
The cost of treatment should not be a barrier to receiving care. At Reasons, we want you to get the help you need, and we’ll walk through the insurance process with you. Call us at 844-573-2766.
Eating Disorders are mental health diagnoses with serious medical complications. Seeking treatment can be a daunting endeavor and navigating insurance, benefits, authorization and on-going reviews while in treatment can be overwhelming to potential patients and family members. Insurance can be one of the biggest roadblocks in trying to get help for an eating disorder, as potential patients are often overwhelmed by fear of how much treatment might cost – but treatment can be life-saving. We’ve compiled some information based on frequently asked questions to help.
In Network Insurance Options
The simplest process is usually when your insurance is “in-network” with the program or provider you are communicating with, meaning that the insurance company has a contract to provide care. Questions to ask about your in-network plan include:
- What percentage of the cost is covered
- How much of your deductible applies and will be due up front
- Whether there are co-pays
- What co-insurance you will be responsible for
What If My Insurance is Out-Of-Network?
If a program is not in network with your insurance, some insurance plans have out of network benefits that you may be able to utilize with BHC Alhambra Hospital Reasons Eating Disorder Center programs.
A single case agreement can mitigate cost. But what exactly is a single case agreement?
Sometimes called a letter of agreement, if a program is not contracted, they can inquire about obtaining a single case agreement with your insurance company. This means a program or provider would set up an agreement with them to cover your treatment stay, without becoming an in-network provider. Geographical location or availability of a bed at an in network facility may impact the execution of such an agreement, either way.
Educate yourself on what your rights are in regards to available treatment options. You may be able to connect with a case manager through your insurance company, if available, to help you locate options and advocate.
Don’t be afraid to ask for help
If you are concerned, we encourage you to reach out and discuss this possibility with us. We are available to work with and pursue various options and agreements with payors, and we are committed to advocating for our patients to be able to access treatment.
Let Us Advocate for You
We want you or your loved one to get the help that they need, and we do not want the cost to be a barrier to treatment. Reasons will work with you during this process by:
- Offering complimentary insurance benefit verifications to determine what your insurance company covers
- Providing a business office ready to discuss private payment options and payment plans
- Helping you navigate through conducting thorough assessments, recommendations for the appropriate level of care, verifying the benefits you have available and advocating for insurance authorization for medically necessary treatment
- Walking together with you throughout your stay to understand your continued coverage, authorizations, step-down plans and any potential for a denial of care from the insurance company
We are contracted with most major insurance providers (in-network) at BHC Alhambra Hospital for the Reasons eating disorder programs (IP, RTC, PHP/IOP). When inquiring with their insurance plan, prospective patients should use the name BHC Alhambra Hospital.
Military Families
We’re proud to serve those who serve and their families, as we work with both TRICARE® and Veterans Affairs (VA). Reasons Eating Disorder Center is ready to start helping you or your loved one get the help they need, and we understand the unique considerations those who serve us need from a healthcare provider.
General Insurance Information
A person may have benefits but that does not mean they can use them automatically or with no restrictions. The care must be deemed medically necessary. We conduct assessments during the admissions process for all of our programs that help us determine if your clinical presentation meets criteria for a higher level of care.
We suggest you obtain a copy of your insurance plan and review your coverage for yourself as well. You should also review deductibles, out of pocket maximums and co-pays, too.
You can work directly with the business office on understanding these amounts and setting up payment plans if needed.
If you have a state based insurance plan, it may be beneficial to request to be assigned to a case manager or advocate who can help you specifically to find a treatment center. If there is not one in-network, perhaps we can help you pursue the single case agreement process.
