Does Medicaid Cover Eating Disorder Treatment?
Getting Help Using Western Sky and Medicaid at Icarus
Watching a loved one struggle with their body image and physically damage themselves over time is an incredibly sad and helpless feeling. When my wife began struggling with her eating disorder again after many years, it was extremely frustrating not to be able to fix things. They need professional help, but sometimes insurance makes receiving effective eating disorder treatment difficult.
If you have Medicaid from Western Sky or other managed care organizations, you’re probably asking yourself, “Does Medicaid cover eating disorder treatment?”
The last thing that you or your loved one needs to worry about is whether or not your insurance will cover treatment. Fortunately, Icarus Behavioral Health worked with our Medicaid plan so that we could just focus on recovery.
Icarus is proud to work with a wide range of New Mexico health insurance plans, including Centennial Care Medicaid, through managed care organizations like Western Sky. Icarus can help you like they helped my family, keep reading to learn more about our story and how we got support for my wife!
Addressing Eating Disorder Treatment With Health Insurance
Eating disorders are a complex condition that often results from body dysmorphia, comorbid mental health issues, societal pressure, and other factors. As a result, they’re difficult to treat due to the mental, physical, and emotional factors that accompany the disorder.
There are also other immediate health concerns that result from conditions like anorexia, including extreme muscle loss that makes it hard for the heart to work effectively.
This was the scariest part for me – not knowing what was going to happen physically during the fight against the mental disorder. However, Icarus’s continued monitoring helped ease my mind.
All of these factors contribute to an eating disorder treatment program often being longer than other programs with shorter-term physical effects. It takes time to help them mentally and work to reverse the immediate physical effects of an eating disorder so that safe body weight is achieved.
Getting Help for Prior Authorization and Extended Care Approvals
Unfortunately, these extended programs can cause issues with insurance. Some insurance plans have limits on how long of a treatment plan they’ll cover, the kind of treatment they cover, and what they consider to be effectively rehabilitated to where they no longer cover treatments.
For example, insurance providers may decide that the severity of the disorder is not significant enough to approve inpatient services or cut their coverage once a target weight is achieved for those with Anorexia Nervosa.
Unsurprisingly, this causes a lot of stress for clients and their loved ones when seeking effective treatment for eating disorders while being able to afford treatment.
Fortunately, Icarus helped us around these hurdles and smoothed the way by helping with paperwork so my wife could get the forms of care she really needed to get (and stay) healthy again.
Are Eating Disorder Treatment Programs Covered by Medicaid in NM?
New Mexico’s Medicaid program is called Centennial Care, which offers comprehensive care for families and individuals throughout the state who meet certain criteria. There are three managed care operators (MCOs) – Western Sky, Blue Cross Blue Shield, and Presbyterian Health – who work with Centennial Care.
Each can help coordinate your care and provide covered services through in-network doctors and facilities that accept Medicaid.
Each MCO has its own network, but as Medicaid providers, they primarily cover:
- Physical health care
- Dental care
- Vision care
- Mental health services
- Some transportation needs
Depending on who you have Centennial Care through, the specific providers and treatments you have access to for eating disorder care will vary.
Fortunately, Medicaid does cover treatment for eating disorders in New Mexico through in-network doctors and facilities like Icarus Behavioral Health. If you have Medicaid through the state of New Mexico like my wife and I did, you don’t have to avoid addressing your eating disorder due to costs – Icarus can give you the help you need.
What Kind of Eating Disorder Treatments Are Covered By New Mexico Medicaid?
Eating disorder treatment at Icarus isn’t a one-size-fits-all solution. While some people might just need guidance, medication management, or therapy to address their concerns, others will require comprehensive, multi-approach treatment plans that span both physical and mental health care.
As someone with Medicaid through the state of New Mexico, many of these treatments will be covered by your mental health coverage, as long as they are deemed medically necessary by medical professionals.
What are the Covered Eating Disorder Types?
Eating disorders include a wide spectrum of different symptoms, both mental and physical, making it crucial that holistic treatment is available to treat the entire disorder. Not every disorder will fit the textbook definition of a diagnosis – but Icarus Behavioral Health can help no matter what you or your loved one is experiencing.
Eating disorders that can be covered by Centennial Care include:
- Anorexia Nervosa
- Bulimia Nervosa
- Avoidant Restrictive Food Intake Disorder (ARFID)
- Binge Eating
- in some cases OSFED (other specified disorders that do not fall into a rigid diagnosis above)
While these are the most common disorders that are treated, there are additional types that treatment can help with. If you’re uncertain about whether you or your loved one’s treatment is covered, contact your Medicaid provider for more information about their health insurance policies.
Does Medicaid Cover Eating Disorder Treatment? Programs and Options
In some cases, individuals with an eating disorder will need to begin an outpatient program before they’re able to receive more intensive care. These include both intensive outpatient (IOP) plans that require attendance according to the treatment plan, usually multiple times per week, and outpatient plans where clients come for regular appointments to receive care. Services provided in outpatient treatment include therapy, monitoring, evaluation, and any treatment that is included in their treatment plan.
If outpatient services are insufficient, your insurance provider can approve inpatient treatment program coverage. As part of inpatient treatment, clients go to the facility and stay there during the duration of the treatment plan. They’ll receive consistent monitoring, daily counseling, guidance, medication management, group therapy, and other strategies to help address the physical and mental elements of the eating disorder.
Both of these options are covered by Western Sky and other Medicaid providers but must be deemed medically necessary by the medical team that treats the individual and the screening doctor as part of the intake. Icarus helped us make sure all the criteria were valid and met and got us help quickly.
How to Get Started with Receiving Treatment for Eating Disorders
Receiving treatment is crucial for addressing and overcoming all types of eating disorders. While the hardest step is accepting help, it can also be stressful to begin the process of coordinating effective care for yourself or your loved one.
Most journeys begin with a referral from a mental health professional like a therapist or psychiatrist, or a general practitioner like your everyday doctor, to receive an eating disorder diagnosis. You can discuss your concerns with your care team and ask about potential treatment options that they would recommend.
You’ll also want to contact Icarus to learn more about your eating disorder treatment coverage, any qualifications that must be met before seeking intensive treatment, their status as in-network providers for care, and any other concerns you or your loved one may have.
Choosing a Leading Mental Health Treatment Facility
Icarus is among the top treatment centers in New Mexico that you can attend for eating disorders, and always helped us determine the right approaches to take.
Medicaid plans are built to be a complete healthcare solution for those who meet the requirements, so it’s likely that your treatment will be covered by the mental health benefits provided by your provider. However, it can be helpful to understand the specifics of your coverage and how it relates to your ongoing treatment plan.
The last step to getting help for an eating disorder is to choose your care team. It’s important to select a facility that is equipped to address your needs with a doctor that you feel comfortable with so that you can focus on your recovery.
We chose Icarus Behavioral Health for our eating disorder and mental health services, and we’re very glad we did.
Get Treatment for Eating Disorders Covered by Medicaid at Icarus
Whether you’re suffering from an eating disorder yourself or you love someone who is, you know how harmful and devastating it can be. Without help, you risk experiencing complications that can greatly diminish your quality of life or even prove to be fatal. However, insurance coverage concerns can make it more intimidating to get started.
If you have a Medicaid plan like Western Sky, you are able to receive treatment from in-network providers for both inpatient and outpatient treatment programs. But you still need to find the right care team to guide you through recovery.
My family chose Icarus Behavioral Health, and I believe you should, too.
They work with Western Sky and other managed care organizers to maximize your treatment coverage and ensure that you get the treatment you need without worrying about your insurance. Their team will help you get started and work with your insurance provider so that you can focus on improving your health through their comprehensive rehabilitation and eating disorder treatment services.
Give them a call today – you’ll be glad you did!