Eating disorder treatment is available to those that have Medicare. Inpatient coverage is ideal for those who desire residential service, and you’ll want to contact Medicare to speak with the case manager. They are your advocate and will collaborate with you on single case agreements so you can get approved. Before the legislation changes anytime soon, you should capitalize on Medicare for your eating disorder treatment.
How Medicare Works
After a case manager has been assigned to you, you will want to inquire about which facilities are available for residential care. Single case agreements can be established with certain facilities to acquire both outpatient and residential care, and if the single case agreement is not available and you’re 26 years old or younger, you can be added to the insurance policy of your parents or another caregiver if it offers coverage for residential treatment.
The majority of hospitals and clinics will accept Medicare when it comes to treating eating disorders. Any center which is partially funded by the state or federal government will allow you to request the assistance of those working at the facility that specializes in eating issues.
How To Get Insurance Coverage
When you apply for insurance coverage it is essential to have a diagnosis for your eating disorder, as well as any physical complications or psychiatric issues that contribute to it. You should also know the recommended level of care, whether it is intensive outpatient treatment, inpatient treatment or partial hospitalization. Those that have outpatient providers can get help in answering these questions prior to speaking with insurance providers. In many cases the facility staff will perform an assessment and speak with the insurance carrier on your behalf.
Benefits You’ll Gain From Medicare
Benefits associated with Medicare are provided via open exchanges courtesy of the ACA, or Affordable Care Act. Medicare is similar to other health insurance systems in that you will be required to receive outpatient treatment before getting more extensive care. Medicare assesses each person individually to determine their condition and the most reasonable treatment they should receive.
Once a doctor shows that inpatient treatment is required for therapy, at this point most insurance carriers will provide coverage for the treatment. Patients that are at risk for relapse without constant supervision and care may not be considered a medical necessity, although mental disorders which are co-occurring could qualify due to the higher likelihood of complications.
How Medicare Covers Eating Disorders
Medicare Part B will sometimes offer coverage for partial hospitalization. It will cover these services when they are provided via the outpatient department of a hospital as well as other mental health facilities. However, Medicare will only cover partial hospitalization when the doctor and program accept the care needs of the patient. Medicare will not cover things such as transportation, testing, meals or support groups. You will also be responsible for covering a portion of the payment for each service which is approved. You will want to go over this with the case manager before beginning treatment to find out what you will pay.