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does medicare cover eating disorder treatment

Does Medicare Cover Eating Disorder Treatment?

Eating disorders, along with their symptoms and treatments, can differ from person to person.

In some cases, treatment for eating disorders may require help with nutrition knowledge. In other cases, someone may need psychological intervention.

And sometimes treatment may also need to address other health problems that the eating disorder causes. So a common question that people have is, “does Medicare cover Eating Disorder Treatment?”

In this article, we answer that question in clear, plain English. You will also find the average costs of treatment for eating disorders, as well as other helpful info.

Does Medicare Cover Eating Disorder Treatment?

The short answer is yes; Medicare may cover the cost of treatment for eating disorders. But not 100% of the time. As is often the case with Medicare, certain conditions have to be met for Medicare to pay for your treatment for an eating disorder. Below we look at what these are so you know what to expect.

Original Medicare (Medicare Part A and Part B) provides coverage for many eating disorder treatments. Medicare offers coverage for both inpatient and outpatient treatment for eating disorders. Coverage may include medication therapy, psychotherapy, and patient education.

Medicare covers residential treatment for eating disorders. However, you will first need to contact them and request an assignment of a case manager. They will act as your advocate and will help you gain single case agreements. They will also discuss with managers and supervisors to attain approval for treatment.

Medicare will cover inpatient treatment if it is medically necessary. It also covers outpatient treatment services for therapy after inpatient care. However, coverage and the scope of coverage may vary on a case-by-case basis.

In some cases, Medicare Part B covers partial hospitalization (PHP) as it provides a program of outpatient services. Part B will cover it if the services are provided in a hospital outpatient department or community mental health center. However, your physician and PHP program needs to accept your requests and care needs for Part B to cover it.

Medicare Advantage plans also provide coverage for eating disorder treatments. They cover everything Original Medicare covers and some additional benefits.

How Much Does Treatment For Eating Disorders Cost?

The answer to this question depends on the level of treatment you need. Residential treatment centers where you stay at the facility are the most expensive. They can cost an average of $30,000 per month.

Even daytime only programs are pricey. They can cost up to $20,000 per month.

For intensive outpatient programs, the cost can be up to $10,000 for a 6 week program.

How Do You Treat Eating Disorders?

Treatment for your eating disorder will depend on your specific disorder. Treatment for an eating disorder may include nutrition education, psychological therapy, medical monitoring, and medications.

In more severe cases, treatment for eating disorders may include hospitalization.

When treating your eating disorders, you may need the help of:

  • Mental Health Professionals
  • Dietitian
  • A medical or dental specialist
  • Loved ones, friends, family

It would be best if everyone involved in your treatment worked together for a more organized way of treating your disorder. Setting a treatment plan and goals may also be necessary for tackling your eating disorders.

Though medications will not cure your overall eating disorders, they will be effective if combined with psychological therapy. But for treatments to be more effective, you will need to take an active role in treating your eating disorders.

Note: Medicare coverage changes all the time. And your specific coverage may vary from plan to plan for Medicare Advantage and Medigap plans. Always be sure to double check with your health care provider and/or Medicare insurance provider about what your plan covers and what it does not.

Additional Info on Medicare Coverage

This article is part of our series on “What does Medicare cover?”

Also, you can check out other articles in this series including: Does Medicare cover skin removal surgery?

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