Eating disorders are a common problem in the United States. In fact, according to the National Associated of Anorexia Nervosa and Associated Disorders, as many as 24 million people in this country struggle with an eating disorder. Whether you have suffered with this condition for a few months or several years, a complete recovery is possible with treatment.
Because eating disorder treatment can be expensive, many people wonder how much their health insurance policy will cover when they enter treatment. This coverage can mean the difference between affordable healthcare services and severe financial distress. If you have health insurance through HealthSmart, consult the information below to determine how much your policy may pay toward your treatment.
Understanding HealthSmart Insurance Plans
HealthSmart is a company that provides services, such as policy design and claims management, to self-funded insurers. Self-funding is a process that allows employers to design and fund their own policies in order to save money and retain more control over coverage.
Although self-funding allows employers to customize the policies they provide, they must still comply with the Affordable Care Act. For this reason, most HealthSmart policies will cover eating disorder treatment.
How Do I Estimate My HealthSmart Eating Disorder Coverage?
Even if you know your policy will cover eating disorder treatment, estimating how much coverage you will receive can be challenging. These plans can vary considerably based on the options chosen by your employer, so coverage amounts differ. To estimate how much HealthSmart Eating Disorder Coverage you will receive, take the following factors into consideration:
- Your Deductible – If you have not already met your deductible for the year, you will need to meet it before HealthSmart Eating Disorder Coverage will begin. Expect to pay at least this amount for treatment, unless the total cost of your treatment is lower than the amount remaining on your deductible.
- Cost-Sharing Requirements – Many services will require copays and/or coinsurance even after your deductible is met. Check your plan documents to learn more about your cost-sharing responsibilities for eating disorder treatment.
- Choice of Provider – Your HealthSmart Eating Disorder Coverage may differ for in-network and out-of-network providers. Learn about these requirements before you schedule any appointments.
- Out-of-Pocket Maximum – Your out-of-pocket maximum is the maximum amount of money you can pay toward medical expenses each year. Once you have reached this limit, all covered expenses will be your employer’s responsibility.