Blue Cross Blue Shield Insurance for Eating Disorders

Eating disorders like anorexia nervosa (AN), binge eating disorder (BED), and bulimia nervosa (BN) are complex conditions that often require comprehensive treatment to overcome.

Unfortunately, eating disorder treatment programs are also often lengthy and expensive. In most cases, people rely on their insurance companies to cover at least part of the cost of care.

If you have a health insurance policy with Blue Cross Blue Shield, keep reading to find out more about the type of eating disorder coverage you may be entitled to and how to secure coverage for appropriate care.

Blue Cross Blue Shield Insurance Overview

Blue Cross Blue Shield (BCBS) is one of the oldest and largest insurance companies in America, extending coverage to more than 115 million people in all 50 states, Washington, D.C., and Puerto Rico, and partnering with more than 1.7 million doctors across the country.¹

The insurance giant has a “Blue Cross Blue Shield Company” in each state and a number of international destinations, where operators handle localized claims for policyholders.² As such, it’s likely that if you have a policy with BCBS, you’ll be able to find an in-network facility or BCBS partner near you.

Regardless, the specifics of your coverage will depend heavily on the type of policy you have. BCBS offers insurance plans for:

• Individuals
• Employers
• Families
• Medicare-eligible individuals

To learn more about your specific policy and the types of coverage you may be entitled to, contact your regional BCBS company.

Blue Cross Blue Shield Eating Disorder Coverage

In many cases, Blue Cross Blue Shield will cover eating disorder treatment under its behavioral health services program, which handles mental health conditions. Depending on your plan, geographic location, and specifics of the case, among other factors, coverage may be extended to:³

• Outpatient treatment
• Inpatient treatment, including residential and partial hospitalization programs
• Intensive case management
• Condition case management programs
• Active specialty management
• Care coordination early intervention (CCEI) programs
• Other medical management programs

Some BCBS companies also work with a specialized eating disorder care team, where an internal team of behavioral health physicians and eating disorder specialists partner together to help recommend patients to the most appropriate type of care and care facilities.³

Exactly how much of the eating disorder treatment cost Blue Cross Blue Shield will cover depends entirely on the specifics of your policy and case. Consult your healthcare plan or contact a representative at your local BCBS company for more information.

What Type of Eating Disorder Treatment Will BCBS Cover?

Again, the specifics of what BCBS will cover depend on a number of individual factors. The best way to find information that pertains to you is to contact the company directly.

In general, most health insurance companies will only support treatments that are considered “evidence-based.” The term refers to therapies and other types of care that have been diligently tested by the scientific community over time and are generally agreed to be effective. Some popular evidence-based treatments for eating disorders include:⁴

• Cognitive behavioral therapy (CBT)
• Dialectic behavioral therapy (DBT)
• Family-based therapy (FBT)
• Interpersonal therapy (IPT)

Many plans will also cover tests and other diagnostic services involved in diagnosing and treating eating disorders, though this will also vary by policy, facility, and other factors.

It’s also possible that BCBS will only cover eating disorder treatment in certain situations. For example, some policies will only cover more intensive types of care, such as residential programs, after a patient tries less intensive options, such as outpatient treatment, or only extend coverage for care up to a certain number of months, hours, or sessions. Make sure to consult your specific plan for more details.

How to Get Eating Disorder Treatment Coverage With BCBS

Before you get started, make sure your specific BCBS policy includes behavioral health program components. This is most likely the program that will cover eating disorder treatment and costs related to other mental health conditions.

In most situations, you’ll need to receive an official diagnosis before the insurance company will extend coverage for treatment. Contact your primary care physician, therapist, psychiatrist, or another licensed medical professional to do so. Depending on your plan, the tests they conduct to determine your diagnosis may also be eligible for coverage.

Once you have a diagnosis, you can contact the insurance company to ask which programs may be available for coverage. Your doctor’s office may also be able to help you with this step, especially if the doctor has given you treatment recommendations.

How to Check if BCBS Covers Your Treatment

Before starting a program, check if BCBS covers treatment for your behavioral health needs. Otherwise, you may be liable for expensive medical bills, fees, and other costs.

You can consult your specific policy to see what types of treatment programs are eligible for coverage. Calling a representative directly is a better, faster way to understand your options. These employees are trained to understand the complexities of health insurance and what your next steps may be in securing coverage.

Navigating insurance for eating disorder care can be a stressful, frustrating process. But following through on some research and planning can make a big difference toward getting the care you need and deserve.