Best Eating Disorder Programs That Accept Medicare (2021)

Each state has eating disorder programs that accept Medicare. Eating disorder Medicare plans, including Original Medicare or a Medicare Advantage plan, will pay some, if not all mental health costs. Any doctor or program you choose to treat your eating disorder must accept Medicare assignment.

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UPDATED: Dec 8, 2021

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Overview

  • Eating disorders are covered by Original Medicare as well as Medicare Advantage plans
  • Eating disorders can be classified as a part of mental health care or behavioral health
  • An eating disorder doctor and/or program must be enrolled in Medicare and accept Medicare assignment

Eating disorders like anorexia and bulemia affect at least 9% of Americans. That’s approximately 28.8 million people. Does health insurance cover the costs of treatment? Yes, most heath insurance companies will cover some, if not all of the treatment costs for eating disorders.

62.6 million Americans are Medicare beneficiaries. Of that number, about 86% of people are Medicare recipients due to age, and the remaining 14% are affected by medical conditions and/or disabilities. All told, there could be millions of Medicare recipients in need of mental health treatment for eating disorders.

If you’re a Medicare recipient, can you find eating disorder Medicare plans that will cover your treatment? Yes, like standard health insurers, Medicare will cover some, if not all costs for mental health treatment. So, what are the eating disorder programs that accept Medicare?

Find Medicare quotes available near you by entering your ZIP code in the free tool above. 

Eating Disorder Programs That Accept Medicare

Medicare is categorized by parts. Parts A and B combined make up Original Medicare. Under Original Medicare, a policyholder is entitled to mental health care. There are several Medicare item list numbers associated with mental health.

These include alcohol misuse screenings, behavioral health integration services, counseling to prevent tobacco use & tobacco-caused disease, depression screenings, mental health care, opioid use disorder treatment services, and telehealth services. Eating disorders can be covered under the mental health care provision for inpatient, outpatient, and partial hospitalization coverage.

Medicare Part A, or hospital insurance, covers inpatient activity. Medicare Part B, or medical insurance, covers outpatient activity, such as seeing a psychiatrist, clinical psychologist, clinical social worker, clinical nurse specialist, nurse practitioner, and physician’s assistant. Medicare only covers the visits when they’re provided by a health care provider who accepts assignments.

Original Medicare will cover: 

  • Occupational therapy (that applies to your mental health treatment only)
  • Individual patient training and education about your eating disorder 

Original Medicare will not cover:

  • Meals
  • Transportation
  • Support groups (excludes group psychotherapy)
  • Testing or training for job skills that aren’t part of your mental health treatment
  • A doctor’s or other health care provider’s office visit
  • A hospital outpatient department
  • A community mental health center

Eating disorder Medicare coverage for Medicare Part C, or a Medicare Advantage plan, depends on the HMO or PPO health insurance plan that was chosen. Generally, mental health coverage, which includes coverage for eating disorders, can be partially or fully covered with a Medicare Advantage plan. 

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How have eating disorder programs that accept Medicare insurance changed?

Eating disorder Medicare changes can occur annually. These changes typically affect your premiums, deductibles, and coinsurance.

You can search for these changes through the eating disorder Medicare item number. Examples of changes that can take place include:

  • Performing a medically necessary exam and/or evaluation
  • Counseling and educating the patient/family/caregiver
  • Ordering medications, tests, or procedures

Find Eating Disorder Programs That Accept Medicare

To find affordable eating disorder programs that accept Medicare, you must locate the proper doctor and/or program. 

Similar to other health care providers that accept Medicare, Medicare coverage for eating disorder programs can only be accepted when/if the program and the doctor are:

  • Enrolled in Medicare
  • Accepting Medicare assignment
  • Accepting new Medicare patients

Once all the criteria are met, you can determine any remaining costs you might incur. Depending on your condition, doctor, and eating disorder program, Original Medicare may not cover the full expense for outpatient, inpatient, or partial hospitalization.

Type your ZIP code in the free tool below to search for Medicare quotes available near you.

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