Why I don’t believe my insurance company cares about me

I recently did a guest blog for Kantor & Kantor about insurance barriers to ED treatment. It’s something I know a little a lot about. I wrote this piece for them, and I’m re-sharing it here. Happy reading!

 

A few years ago, I received a postcard in the mail from my health insurance company. It said something along the lines about how they “cared about my health” and would “always be there for me.”

The offending piece of paper cued a half-hour, f-word laden rant about the hypocrisy of such statements. When I was critically ill with my eating disorder, in an out of the ER several times a week, they refused a higher level of care, saying it was “not medically necessary.” Never mind that my own physician, my therapist, and even the doctors in the ER were saying adamantly that if I didn’t get treatment, I would die.

I’m not quite sure how these actions come from the same company that supposedly cares about me.

Eventually, my parents and I got sick of the games and raided our collective savings to send me to a treatment program at the cost of $1000 per day. The insurance company refused to even consider a single case agreement or hear an appeal until I was discharged.

I was at the facility for seven months. You do the math.

The problem is that residential treatment—even the best residential treatment—doesn’t fix you. I left without a good transition plan or any real clue about how to eat in the real world. The treatment center saved my life, absolutely, but I wasn’t well, not by any stretch of the imagination.

It will come as no surprise to those in the eating disorder community that I relapsed shortly after leaving treatment. With a long-term, chronic eating disorder, even seven months was not enough time to get my disorder into remission. I needed supervision and support at every meal for a long time, which was something I didn’t have after discharge, and something no one told me I might need. Because I couldn’t do recovery on my own, because I felt I had failed treatment again, because I knew that my insurance company wasn’t going to pay for further treatment, I felt I had become a burden to my family and society. So I tried to take my own life since I didn’t see things getting better.

Obviously, I survived.

The suicide attempt scared my parents and, in retrospect, it scared me. In a sense, it helped spur me on to recovery because it was clear I probably would not survive another relapse. My treatment team insisted I move home where I got the 24/7 support I desperately needed, where everyone could be sure that I ate every meal and every snack every single day. No exceptions. As in residential, I was giving only a limited say over my intake- my treatment team and my mom determined the exact amounts. I worked hard in therapy. Recovery was my full-time job.

It was probably the most difficult thing I had ever done. But for the first time in more than a decade, my weight reached the level where it needed to be. With so much structure and support on the eating front, I could focus my time in therapy on anxiety and depression, rather than by lurching from crisis to crisis.

As an eating disorder blogger, I hear a lot about people’s insurance problems. It’s the rule, rather than the exception, that an insurance company fails to pay for treatment deemed necessary. These decisions are obviously made with an eye towards the bottom line, rather than the patient’s health. It’s hard enough to fight an eating disorder, and yet patients and families have to battle both the disorder and the people who you are paying to help provide medical care.

My response to the insurance company’s postcard today is the same as it was a few years ago. I ripped the damn thing up and told them to go shove it. I’ll believe they care about my health when they stop being a barrier to getting well.

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6 Responses to “Why I don’t believe my insurance company cares about me”

  1. YESSS!!! I went through a similar process with my insurance company. They cut out once my weight reached triple digits because they believed that was the “cure.” All I really have to say is, the level of ignorance and lack of compassion insurance companies show towards ED treatment is disrespectful, despicable, and disgusting. Something needs to change.

  2. Re. the above comment, something most definitely needs to change, the attitude and ignorance (or if it’s not ignorance but simply unwillingness to ‘cough up’, then that’s even worse!) Perhaps there should be a Carrie Arnold-led conference to highlight the impact – and repercussions – that their idiotic ‘policies’ have on so many lives: coming from such an eloquent, intelligent, fair and knowledgeable ED ‘ambassador’ I can’t believe that at least SOMEONE wouldn’t sit up and think, ‘Hey, wait a minute, maybe we should think about this…’ Then again…!!! One can but hope! Thanks, Carrie, for all your brilliant posts.

  3. I’ve thankfully never had to tangle with insurance as I’m in Australia, but have read the stories of people who have, with horror. Things like people being kicked out of hospital at 10pm at night because they couldn’t afford another $1000 to even stay til morning after their insurance cut out, or travelling across the country for ED treatment and having it denied when they get there.

    I’ve long felt that many of the ‘miracle’ treatments/clinics that have opened up for those with ED’s even here in Australia take advantage of those who are desperate. I’ve seen families mortgage everything to try and save their loved one’s life, run out of money, and be callously dropped by the same clinic that promised them cure.

    I do think that it’s true that no eating disorder program can ‘cure’ anyone. I’ve often wondered if I might get better if I were able to go to a private clinic instead of the public ed program, or go overseas to one of the places i hear about all the time – and keep coming back to this – if I’m not ready to change and to help myself, all of the most miraculous treatment in the whole world will not ‘fix’ me. And yet, when I AM ready to accept help and to help myself, my basic local ED program support should really be enough to help me gain and maintain weight because I am working WITH them, and the therapist I already have who I’ve come to trust etc. I think it’s a combination of not just having people who are skilled at working with those with ED’s and compassionate, but being ourselves ready to help ourselves too.

    I don’t think any insurance company should ever be able to tell people ‘you aren’t sick enough’ or ‘you have the wrong diagnosis’ or ‘this is how much treatment you need’ – ever. They aren’t the treatment team for a reason. You can’t reduce lives to set quantities and rules, either.

  4. I have to say that I’ve actually been pretty lucky on the eating disorder front—my insurance company has covered pretty much all my treatment, with the obvious caveat that I’ve never done residential or inpatient, so my treatment has been vastly less expensive than others’. That being said, I’ve had problems getting coverage for treatment of other medical problems, and I think the main problems arise when established treatment guidelines don’t match up with emerging research, changing medical protocols, physician creativity, and actual clinical practice. For example, I have a wonderful chronic pain specialist who addresses my issues on multiple fronts and has given me incredible relief where no other doctor was able…the downside is that his office does not take insurance because there were so many problems getting coverage that they finally just gave up and starting taking full payment in cash. Patients can submit and appeal for coverage independently, but damn that is a headache. I have no illusions that my insurance company “cares” about me because after all, it is a business—however disillusioned that may sound. Until policy catches up with research and until we fix the broken healthcare system in this country, it takes an exhausting amount of persistence and willpower to get anywhere near the right level of treatment for chronic, poorly-understood illnesses.

  5. Reading this reminds me of the same situation many of the in-patients when I was being treated. While being there for 3 months there were a few patients who were trapped in a revolving door. After their insurance would throw them out of treatment too soon, they would end up in the emergency room to be tube feed, and then back to inpatient for a few weeks.
    I wonder how many ED sufferers lives have ended in a suicide or lives have been compromised by the inhuman treatment by their insurance companies. ED is so damn hard to fight on its own, adding unneeded stress, despair and guilt on top of that, is the makings of a disaster. Carrie, I am so thankful that you are still with us. It makes me mad as hell that you were in this financial situation and suffered so much. With your voice empowering so many, perhaps together we can win this fight against the insurance industry.

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