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Media Monday – Denied Coverage for Not Purging Enough

Submitted by Christine Hanwick

A 19-year-old woman from Los Angeles was denied inpatient coverage for treatment because the insurance company claimed she was not “purging enough.” They actually denied her because she was not “purging enough.” I needed to repeat that twice because it seems too awful to believe. This young woman who had the courage to seek treatment was life-flighted to a hospital after having been sent away from an emergency room she was admitted to because of stomach pain–where she was actually told “to go home and deal with the consequences of [her] behavior.” She later passed away from septic shock induced by a ruptured stomach caused by binging and purging (bulimia). The insurance company paid for the emergency room visit–but they wouldn’t pay for treatment of the illness that caused her death (Source) (Source).

I think most people would agree that this is a tragic story that could have been avoided had she not been denied coverage. But she was, and unfortunately stories like this happen too often. I read about this story in the Hill Blog, which said that “the lack of access to quality mental health and addictions services is one of the most important and most neglected civil rights issues confronting the nation. Care of the mentally ill is one of our greatest and most enduring health disparities and one of the country’s most resounding failures” (Source).

Although we as a nation have failed to ensure “access to quality mental health and addiction services” (Source), we have finally implemented the Affordable Care Act, which is supposed to ensure that mental health and addiction treatments are covered. I’ve been reading about the Affordable Care Act, and trying to decipher whether or not it will have a big impact on improving coverage for the treatment of eating disorders. To tell you the truth, I’m not sure. Only time will tell. But there are some really beneficial inclusions, like enabling individuals to stay on their parents insurance until the age of 26. I do think it’s a huge step in the right direction. And I believe that in combination with the Mental Health Parity Act and hopefully soon the FREED Act–there will be continued progress for treatment and prevention.

We as individuals can help to make sure there is progress for treatment and prevention. We can read stories like the one mentioned in the Hill Blog, and it can deeply impact us. And the power of a story like this, is that if you are passionate about seeing progress for treatment and prevention, perhaps it moves you to write a letter or make a phone call to your legislator. If this is something you feel compelled to do, I’ve added two links below to sample letters you can easily add your name to, print out, and send to your legislator. One is about the FREED Act, the other is a sample letter for action.

“We must hold the government, insurers, and providers accountable until every person who is in need has access to affordable, quality mental health care. Only then will we have achieved a truly equitable system, and ended the historic discrimination in mental health care” (Source).

FREED Act sample letter:

http://www.eatingdisorderscoalition.org/documents/RepresentativeSampleLetter2012.docx

Sample letter for action:

http://www.anad.org/wp-content/uploads/2012/07/Sample-Legislative-Letter.doc

Sources:

http://parityispersonal.org/sites/default/files/hearing%20report.pdf

http://thehill.com/blogs/congress-blog/healthcare/327013-make-good-on-mental-health-parity

Image: Source

 

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