My Treatment Team Says I’m Sick, But My Insurance Company Says I’m Not Sick Enough

insurance says not sick - image of woman in bathtub with hands covering her face, woman is wearing a white t-shirt

“We heard back from insurance yesterday about sending you to a higher level of care. They declined it saying that it wasn’t ‘medically necessary’. I’m so sorry.” My whole body went numb. I’m pretty sure I stopped breathing. I was hyper-aware of my heart beating in my chest as tears began cascading down my face. I needed more help with my eating disorder. But my insurance company said I wasn’t “sick enough”.

It’s Not Easy

I was struggling so much that my therapist wanted me to start a higher level of care. We made a plan that satisfied everyone. I went on with my day and I didn’t think anything of it until the program director called me into my therapist’s office.

“I just want to prepare you for this. This isn’t going to be an easy conversation.”  A million thoughts went through my mind.

                Were they kicking me out because I haven’t been meal plan compliant?

                Were they going to send me somewhere else because they had given up on me?

                Was there no money left to pay for my treatment?

Honestly, any of those would have been better than what the program director told me.

When Insurance Doesn’t Get It

I had spent my whole life trying to prove to doctors, therapists, psychiatrists, even myself, that I had an eating disorder. But I didn’t look like I had an eating disorder so did I really have one? Was I really that sick?

Time after time, I suffered eye rolls from nurses when I asked to step on the scale backwards. Time after time I had doctors tell me to lose weight just moments after I told them that I had an eating disorder. And that I wasn’t open to any unsolicited weight related advice. Time after time my therapists ignored my eating disorder to focus on my mood and anxiety problems. They assumed, all the while, that my eating disorder was under control.

Why?

Because I “Looked Fine”



Fast forward to my first semester of graduate school. I was in my dream program. I was studying a subject I was really passionate about in a city that I loved. With an amazing apartment with friends, and literally the cutest cat you have ever seen, I thought that I had it all together. And I was focused on doing well in school. As a result, I completely blocked out how incredibly sick I was.

Right before I was to go back to school my therapist told me that she thought I needed a higher level of care. There was another facility nearby accepting new patients. With angry tears in my eyes, I remember clenching my fists so hard that my nails were digging into my palms.

I am NOT sick. I am just fine!

At the time, I really did not like that therapist or what she had to say. But she was one of the first people that truly saw me. She recognized that I was completely immersed in the disorder. And she understood it was tearing my life and my body apart.

I agreed to go to the higher level of care and admitted the next day. While I never wanted to go to this new facility, it was truly the turning point in my recovery. And honestly, it probably saved my life.

I Felt Seen

Suddenly, I was surrounded by people who were informed about life in a larger body. People who looked past my weight and disregarded my BMI to see me for who I truly was. And just how deeply I was suffering. My struggle had never been seen as valid. It had never been taken seriously before. But it was different here. They were worried about me. This was so new to me. There was certainly an adjustment period to go through in order to truly believe that these people really cared about me. Unfortunately, I needed more help.

Blinded By The Numbers

The crushing news of my insurance’s inability to look past some made up numbers sunk me. Terrified, I felt like I had just been handed a death sentence. And then the program director said something to me that changed my whole perspective:

“I need you to keep holding on. I need you to keep fighting. I need to have a world with you in it.”

My treatment team worked out a schedule that would best help me get back on track with meals and snacks that had been historically challenging for me. They ramped up the words of encouragement and praised me for my small victories. And they were even more excited than I was when I came in with a big win against my eating disorder.

The Lesson

The moral of the story here is that if you are in a larger body, I see you. I hear you. I’m right there with you.

Regardless of your body size, I need you to know that your struggle with this disorder is just as valid as those in a smaller body.

We are all fighting the same battle and don’t let anyone tell you differently.

Your pain is just as valid. And your trauma is just as valid. Your experience with an eating disorder is just as valid.

And I need you to know that there are some good guys out there fighting the good fight for us. They are educating medical professionals, they are advocating for policy change. And they are speaking up when our voices are silenced. And when it’s too much emotional effort to speak for ourselves.

They exist. I promise you, I need you to keep holding on. And I need you to keep fighting. Because I need to have a world with you in it. And yes…. I’m talking to you.


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