QUICK TIPS: WHAT DO I REALLY NEED TO KNOW?

  • It will be helpful to know what your policy does and does not cover, whether you are actively in treatment. Find out the information you need to know when looking for treatment options, either by calling your insurance plan, or by signing up and accessing your insurance company’s online website.

    Does my plan pay for eating disorder-specific treatment? What levels of care does it cover?

    Does my plan pay for outpatient therapy or outpatient medical nutrition therapy?

    Does my plan have out-of-network benefits? If it does, how do I work with an out-of-network provider?

    What is the cost of my deductible, out-of-pocket max, co-pay?

    If I don’t have out-of-network benefits, and there are no in-network options available to me is a Single Case Agreement possible?

  • They can provide you with an emailed list of in-network providers, treatment centers in your area, and aftercare planning when you are getting ready to step-down or discharge from a higher level of care.

  • In some insurance plans, a Behavioral Health Case Manager may be referred to ask a Case Manager or Care Coordinator. Being assigned a Case Manager is included, at no cost, within your insurance plan. A Case Manager will act as your advocate from within insurance, and they can also directly provide you resources for providers, treatment, etc. Call your Member Services number to ask about being assigned a Case Manager.

  • An appeal for denied services can be completed at any level of care (Inpatient, Residential, Partial Hospital, Intensive Outpatient, and Outpatient Therapy/Nutrition Therapy.

    Keep reading on in these insurance guides to learn more about each area listed above, as well as how to further navigate your insurance coverage.