You know you need help for an eating disorder—or someone you love does—but you can’t figure out if you can afford treatment, and it’s keeping you stuck.
Insurance policies are written in language that’s deliberately hard to decode. You need to know what your plan covers and what you’ll owe, and getting that information is difficult—especially while you’re also dealing with the stress of an eating disorder.
You don’t have to figure this out alone. This blog walks you through what insurance typically covers for eating disorder treatment, how to determine what your plan includes, and the steps to take to get clarity.
Does My Insurance Cover Eating Disorder Treatment?
While it depends on your specific plan, most insurance plans do cover at least some eating disorder treatment. To understand what your plan includes, you’ll need to verify your benefits.
The Emily Program is in-network with most major insurers across the states where we have locations. That means that instead of paying the full cost of treatment yourself, you’re typically paying your plan’s deductible, coinsurance, and/or copay (the same way you would for any other mental health service your insurance covers).
How much your specific plan covers depends on the insurance company you have, the state you live in, and the level of care you need. But the question usually isn’t “Will insurance pay for any of this?” It’s “How much will insurance pay, and what will I owe?”
What about Medicaid?
If you have Medicaid, coverage varies by state. Check our insurance providers page (below) to see what’s available in your state, or contact our admissions team—we’ll help you figure out what applies to you.
See which insurance providers we work with in your state
What Services Are Typically Covered?
By law, most insurance plans are required to cover mental health treatment—including eating disorders—at the same level as they cover medical treatment. This is called mental health parity.
Your treatment team determines what level of care you need based on a range of factors. Insurance companies then decide whether they’ll cover that treatment. This determination is called “medical necessity.” While their criteria can feel frustratingly narrow at times, most plans do cover various levels of care, including:
- Outpatient treatment: Regular appointments with a therapist and dietitian
- Intensive Outpatient (IOP): Several hours of treatment multiple days per week while you’re living at home
- Intensive Day Program or Partial Hospitalization (IDP/PHP): Full-day treatment programs with evenings at home
- Residential treatment: 24-hour care in a structured treatment setting
- Inpatient hospitalization: Medical stabilization for serious physical complications in a 24-hour care treatment setting
Our utilization review team handles the prior authorization process, working with insurance companies to explain why specific levels of care are necessary.
It’s deeply frustrating when an insurance company approves less care than what’s clinically recommended, or denies coverage entirely. It happens, though it shouldn’t.
Sometimes insurance authorization ends before a patient has completed their clinically recommended treatment plan. Research shows that early discharge significantly increases relapse risk and leads to worsened long-term health outcomes. This is part of a larger pattern: insurers sometimes prioritize cost containment over clinical judgment, a problem documented across the country. This is why The Emily Program advocates nationally for better insurance coverage and works with families to navigate their options when barriers arise.
Questions to Ask Your Insurance Company
The best way to understand what you’ll actually pay is to contact your insurance provider directly. Our admissions team will verify your benefits after you schedule an initial assessment, but calling your insurance yourself will give you the most accurate information about your costs.
We’ve created a comprehensive guide to help you know exactly what to ask. It walks you through the conversation step by step, so you’re not trying to figure out what questions matter while you’re on hold with customer service. The guide covers questions like:
- Is The Emily Program in-network with my plan?
- Do I need a referral to begin treatment?
- What’s my copay, deductible, or coinsurance for outpatient, IOP, IDP/PHP, residential, or inpatient care?
- Does my plan require prior authorization for treatment?
- Are services like dietitian visits or telehealth appointments covered under my mental health benefits?
The guide also includes questions specific to each level of care, so you’ll have the information you need if your treatment recommendation changes.
One important note: Some insurance companies have a separate organization that manages mental health benefits (called a managed behavioral healthcare organization, or MBHO). When you call your insurance, they’ll tell you if this applies to your plan and how to contact the right team.
Download the full guide: What to Ask Your Insurance Company
How The Emily Program Helps Navigate Coverage
Insurance is complicated, and you shouldn’t have to become an expert in it while you’re dealing with an eating disorder. Our admissions and finance teams handle much of the confusing work:
- Insurance verification guidance: Our comprehensive guide helps you verify your coverage with your insurance company. This tool walks you through exactly what to ask and provides space to document the answers you receive.
- Prior authorization support: Many insurance plans require approval before treatment can begin. We typically handle this paperwork and work with your insurance company to explain why specific levels of care are necessary.
- Claims submission: We submit claims to your insurance company for reimbursement after services are provided, so you don’t have to manage that paperwork yourself.
- Payment options: If you’re experiencing financial hardship and want to start or continue treatment, call us at 1-888-272-0851. We’ll work with you to help find a solution.
- Ongoing support: Insurance questions don’t stop after you start treatment. Our teams continue helping throughout your care.
Unfortunately, insurance sometimes denies coverage or approves less than what’s clinically recommended. When that happens, we work with families to understand their options—whether that’s filing an appeal, exploring alternative coverage, or discussing payment plans. You don’t have to navigate this alone.
Financial Assistance Options
If cost remains a barrier even after exploring insurance coverage, there are organizations that provide financial assistance for eating disorder treatment.
Project HEAL offers grants to individuals who need financial help accessing care. Their application process considers financial need, and they work with treatment providers nationwide, including The Emily Program.
Additionally, our admissions team can discuss payment plan options that make treatment costs more manageable over time. Cost concerns are real and shouldn’t be dismissed—but they shouldn’t be the reason someone can’t get help for an eating disorder.
Taking the Next Step
If you’re considering treatment, the best place to start is by calling our admissions team at 1-888-272-0836. They can:
- Verify your insurance benefits
- Explain what’s covered in clear terms
- Provide an estimate of your insurance coverage for the recommended level of care and treatment program
- Answer questions about the treatment process
You can also check whether we accept your insurance on our website, though contacting your insurance company will provide the most accurate and personalized information.
Insurance is complicated, and navigating it while dealing with an eating disorder shouldn’t fall entirely on you. At The Emily Program, we work with families every day to understand coverage and make treatment possible. The question isn’t whether recovery is worth pursuing; it’s figuring out how to access the care you need. We’re here to help with that.
If you or someone you love is struggling with an eating disorder, and cost concerns have been holding you back from seeking treatment, The Emily Program is here for you. Call 1-888-272-0836 or complete our online form to learn about your options. Recovery is possible, and we’re here to help make treatment accessible.
Founded in 1993, The Emily Program is nationally recognized for our compassionate and personalized approach to eating disorder awareness, treatment, and lifetime recovery. We understand the tangled complexities of eating disorders, often from personal experiences. We know that you’re not defined by your eating disorder, and our team of experts—including therapists, dietitians, and medical staff—focuses on treating the whole person. We provide an integrative approach for people of all ages and genders who struggle with eating disorders and related mental health and body image issues. The Emily Program care teams bring decades of experience managing the unique medical and psychiatric complications of eating disorders. With convenient locations in GA, MN, NC, OH, PA, and WA or within a virtual environment, The Emily Program is here to help you no matter where you live. For more information, please visit emilyprogram.com.