Should insurance cover healthy meals?

Since my reader emails seem to spark lots of great convo and controversy, let's get this week off to a fiesty start with the following letter from reader Amanda:

"I've had an ED for about 3 years now and I'm still struggling...I've read on your blog several times about how insensitive insurance companies are towards eating disorder patients and helping pay for the enormous cost of treatment. So far, my insurance (Anthem) has been fairly helpful... until now.

A few months ago, I started ordering weekly meal delivery from a program called Seattle Sutton's Healthy Eating. It provides complete meals that are balanced with good fats, carbs, and protein. For a girl who has been scared to death of any carb or fat and literally lived on the same 8 foods every day for over a year, this program was a godsend. I actually get to eat muffins and ravioli again. I had not eaten those things in years before this program. I've also gained maybe10 pounds (except I don't weigh myself, just clothes fit better). Needless to say, this program has given me hope of being normal one day....

Here's the kicker: the meals cost $135 a week. Yea, ouch. I am trying to get my insurance company to pay a portion of it, like a co-pay. But I don't have a doctor to show that I am still suffering from an eating disorder. I'm going to submit a claim, but I have a bad feeling that they will poo poo the idea. Maybe it's just me, but wouldn't it be cheaper to pay a little bit for meals now so that I actually eat rather than paying for hospitalization later because I was too scared to eat so I just didn't? Because I AM petrified that I will revert to old habits if I don't have healthy meals that have the fats and carbs I need."

Devoted WG readers, what say you? On one hand, it makes sense to incentivize people - ALL people, eating disordered or not - to eat healthfully, considering how a balanced and functional diet will help ward off future health problems. On the other hand, I can barely get my insurance company to cover my physical therapy sessions as prescribed by my back doctor...let alone ask them to chip in for low-fat meal delivery service. I actually think they would laugh at me if I asked them this. Which is why Amanda and I are asking YOU, people with actual compassion and insider understanding of how disordered eating can throw your whole world upside-down.

Thoughts?

PS Amanda is now my favorite person because in her email she wrote, word-for-word, "Can you use your big, strong, Amazon woman-in-a-brace power to raise a fuss about stingy insurance companies?"

Comments

Obviously the healthcare system in the UK is funded differently to the States, but I imagine if anything like that was suggested over here there would be UPROAR. But that's because we have public funding.

I can see how such a programme might be useful for recovering anorexics. However during my recovery I found it more important to learn to look after myself FOR ME and take the responsibility for feeding myself. Thrown in at the deep end. It was really bloody hard and terrifying but the end result has honestly been worth it. I suspect if I had used a meal delivery service to ease me into eating properly I would have become overly reliant on it eventually.

As a short term strategy I think it could be useful, but I think you'd need a time limit on it, otherwise it's potentially just another dependency to overcome?

TA x

This reminds me of your orthorexia post a few days ago, actually. The meals might be healthy, but I promise Amanda can make healthier meals if she gets her behind into the grocery store and buys some REAL FOOD. Those prepackaged meals are full of sodium and other preservatives, not to mention the fact that they lose some of their nutrients being frozen and reheated. Sorry, but my opinion is that the frozen meals are not really making you better, Amanda. They're a crutch. I would prefer for an insurance company to pay you to see a dietician who can teach you how to put together healthy meals rather than a meal service. How long do you plan to eat prepackaged meals anyway? Indefinitely?

Anyway, good luck with your recovery. Can't wait to read other peoples' comments!

First insurance companies do cover food while you are in an in-patient program. Once you are out they cover meeting regularly with a nutritionist who can help you design a real-life meal plan to help you get back on track. I'm not trying to be harsh but, as a formerly ED'ed girl myself, you do need to learn to take care of yourself. There will be times when you have to eat outside of your home and it's best to learn how to choose foods that will make you healthy and happy.

I'm so proud of you Amanda for working so hard to get to the point you are at! You deserve huge kudos for just eating and for making a comittment to recovery. There's nothing wrong with using the meal service as part of your recovery plan but just know it's only part of the process, not the end goal:)

Besides, if we ask insurance companies to pay for the meals for eating disordered patients, then we must also offer them to people with other illnesses that could be helped by healthy food... which would be pretty much everyone.

My husband's place of employment has an "employee health initiative" which reimburses a certain amount of money spent on lifestyle changes...

My husband and I have used it to pay our Weight Watchers memberships, but that money can also be used to pay for gym memberships, vitamins, or other wellness programs. Perhaps she could look into that as another option... healthy employees are more productive employees, and I'm sure her employer would rather pay a little now and then towards eating, than paying her for countless sick days. Depends on the company, I suppose. Still, no reason not to check.

I do think that, when prescribed by a doctor as a part of a comprehensive medical treatment plan, food should be reimbursed for both those recovering from EDs as well as those that are morbidly obese and trying to lose weight.

However, from what I gathered from the letter, she has chosen this route fo eating in the absence of any doctor recommendation or guidance. And, because of that I'm not so sure I think she should get reimbursement. She has chosen this course because it makes her feel comfortable, but there seems to be little medical basis on which it is based (and those that commented above who are also recovering from EDs seem to disagree with her strategy).

And while in theory it would be great for health insurances to incentivize healthy habits...at some point we all have to take some responsibility for ourselves. I could feed my family hamburger helper and no fresh produce every day because it is less expensive than what we eat...but I don't. And I don't expect any reimbursement for that.

Hey, this is Amanda!
First of all, thanks to Leslie for posting this. Second, thanks to all who have posted their ideas and encouragement.
I wanted to comment on a few recurring thoughts that others have left...
1. This is NOT Nutrisystem. The meals aren't frozen or dehydrated or mutilated in any way. They are developed by a former nurse and nutritionst and are completely fresh. Go to www.SSHE.com if you want to check it out.
2. Yes, I don't doubt that it would be cheaper to buy and make my own meals. But I've tried that route and ended up eating the same food every day for over a year. That is why I started the meal delivery.
3. In patient care would cost WAAAAY more than this service. The low end estimate would be $198 PER DAY out of pocket for treatment. Insurance would cover the rest, about $900 a day. Obviously the meal service is cheaper for both parties.
4. No this is not in place of a doctor. I was seeing a doctor, but she deemed me "well enough" to be discharged.
And thus brings my story =)

Amanda,

First of all, it's great news that you're on the recovery path and well enough to be discharged by your doctor. And I think that this meal delivery service could be a good option in the short term. But I also think that other posters have a point that this isn't a long term solution. It's important to be able to provide for yourself (and much cheaper). And if this means cooking off of a meal plan (rather than cooking what you want to cook that day), then it might work better than just trying to "eat healthy" in an open-ended way. But I've never had an ED, so I don't really know how hard that actually is.

I think that it would be very difficult to get insurance to pay for this, because everybody should be eating healthy meals, and I'm not sure they legally could offer it to you without offering it to everyone else (even if just limited to people with food-related health issues).

That said, it must be very difficult, and I wish you best of luck!

My thoughts are that in general the health care system should have a lot more funds to help people in situations like this. And Amanda has a great point that its better to fix the problem now than let it persist so that later on down the road there could be more complications and more expensive. But our governments unfortunately tend to be more short-term thinkers than long-term.

Hey Amanda, congrats on your recovery thus far. It's really great news that you're doing so well and have found a meal system that works for you.

But in general, I do have to agree with Charlotte's comment in its entirety. I don't think a meal delivery service is a viable long-term solution and I don't honestly think it's your insurance company's problem if you find your meals get too repetitive if you cook them yourself. There are endless healthy, less expensive food options out there - challenge yourself to try new options that you know are healthy because you've looked up the nutritional info before making them.

I am glad this is working for you but I don't think it's the insurance company's responsibility to cover your food costs. If this is truly the best route for you, then I think you need to find a way to boost your income so that you can afford to pay for it on your own.

I have to agree with Charlotte and others. While I might not complain if it was something like the insurance covered a month of meals to teach someone what kind of healthy meals they should be eating, teach someone appropriate portions, or something, as a long term idea, no way. Really, I support a universal health care plan and think anything necessary should be covered, but food is something everyone must have, so how could they possibly justify free meals for some but not for others? Why couldn't someone who is diabetic say they need meal delivery because it treats their diabetes? Or someone else with a family history of diet-related illness claim healthy meal delivery is preventive?

I feel for Amanda - truly - but there's got to be another, better way, and meal delivery cannot be a lifelong thing. The sooner she starts learning how to do it herself, the better.

I think the thing is with this case is that regardless of if Amanda was sick or not she would still have to eat to live, right? So why should the insurance company be paying for that? It doesn't really seem "important" enough to warrant being covered by the insurance. Some people have cancer and go through chemo and it is a big stretch for their insurance to even cover a wig. Also, it is like in the Bible where you give a man a fish and he eats for a day, teach him HOW to fish, and, well, you know the rest. I think the insurance company would probably be fine with covering appointments with a nutritionist or dietitian, bc then Amanda would learn HOW to provide for herself in a healthy way. And counseling too to help her not get into that same situation of the same 8 foods a day.

I can somewhat sympathize with Amanda, though my story's a bit different. I've had a history of juvenile rheumatoid arthritis since a very young age, and still have a hard time finding doctors to take me seriously as a young woman with an "old person's" ailment. Eventually, I had to take measures into my own hands, adopting a diet and exercise routine in an attempt to control the pain and symptoms. But no matter how much all that has improved my condition, how could I even start to submit a claim for the gym membership and trips to the farmers market that have gotten me this far? And, as others have said above, why should the diet and exercise that is controlling a disease I already have somehow be more relevant than the diet and exercise of someone else who might be preventing some unforeseen future disease?

Healthcare reform is something very close to my heart, and as great as it would be to have preventative health covered by insurance, we have far greater problems with our current system to deal with first.

Rhodeygirl- have YOU ever had and ED? Obviously not if you think weighing under 100 pounds is not "important" enough to warrant a meal plan for help.
Sorry, but I've suffered for too long from this disease to see it as a whim or a way to con insurance companies. Yes, it is probably a stretch to get coverage, but you never know until you ask... or die trying.

First of all, I agree with Rodneygirl above. I think it is great that Amanda has gotton to this point, but she needs more help. She needs to learn how to grocery shop, that it is ok for her to cook with oil, etc. That is part of ED recovery. She needs to find an RD and therapist that will help her with these issues.
Gina- I have had an ED, and I had to LEARN how to grocery shop and prepare foods so that I could eat like a "normal" person again. I once weighed under 100 pounds at 5'7". I do not think that Rodneygirl was saying it is not "important" enough, but the fact is, I don't know any insurance company or disease that would warrent having food covered. As she states, everyone has to eat. People that can't cook or afford food must unfortunately be put on a waiting list for Meals on Wheels, and other programs that often take months to start getting. I think you should think about your posts and read others before you start attacking a reader. If you are suffering from an ED, please seek the help you need.

Great discussion!

I think it's a hard issue, but I have to agree with those who think meal delivery should probably be at most a temporary, not permanent part of treatment planning. I can't say it nearly as well as those who've already expressed it, but I do think there's a limit to how long it makes sense to have someone else responsible for meal prep and planning when it seems like learning to do it oneself would be an important part of the recovery process.

Amanda, hope you are able to continue your brave journey towards recovery; sounds like you've come a long way already.

I'm going to agree with Charlotte and give you lots of kudos for getting this far..But, can you start to ween yourself down and learn to cook the meals that are being delivered? There's lots of great recipe books out now on healthy eating! It's taken me years to figure this food thing out. But, live is so much more enjoyable now!

Amanda again...
Thanks for all the comments, I never thought it would be such an interesting or volitile subject!
I know it should (and it really is) a temporary band-aid. When I stop the meals, I will be faced with having to cook for myself again, and that is an enormously scary thought. But for now, I was just hoping someone would have an idea on how to approach an insurance company in regards to eating disorders. They are so costly and so far, very few insurance plans cover the lengthy treament EDs usually require. Maybe if I work out an ending date with my insurance company so they know I'm not trying to bilk them, they might be more willing. Any thoughts?

My insurance won't even pay for my art therapist. My parents pay a hundred dollars a pop for that. And for the other three treatment people I have my parents must pay co-pays plus co-pays for meds and gas money. We are in serious debt and that only makes me feel guilty and my disorder worse. all of our savings have been used up and I don't know if i will be able to pay for college.

Amanda - Since you are able to eat the meals that you receive perhaps you could talk to the nurse/company that makes them about teaching you how to make their specific meals. And I don't just mean how to cook them but the whole bit. For example, perhaps they would let you shadow them when they plan what they will send, then go to the market with them when they buy and then go through all the prep and cooking bit. If they aren't receptive to the idea perhaps the insurance companies would pay you to get some lessons similar to that. I'm sure you could find a nutritionist or personal cook who would be willing to do that with you.

Just a thought! Good luck on your search for the right answer!

Amanda- I feel your pain, really I do. ED are outrageously expensive. I was in therapy for litterally 10 years on and off, until just recently, about a year ago, I felt like I finally didn't need to go. I was fortunate that my parents paid for about the first 4 years of it, but after that I was on my own. My therapists let me be on a sliding scale fee which made them some-what affordable. And yes, I would talk to your insurance company about it. Not to rain on your parade about the ending point idea (which is a good one in theory!) but you never really "end" or stop having an ED. It just becomes easier to manage. So you never really know how long you will need treatment for. I stopped numerous times only to relapse and have to go back again for more treatment. Hope this helps some. Feel free to email me privately and I may help you with any more questions! You are doing great though and don't give up!!

I suffer from an ED as well but haven't sought professional treatment for it. I've been trying to cope with the support of family and friends. In my opinion, part of the recovery is learning to make my own healthy meal choices, meal by meal, snack by snack, day by day. I don't think it's the health insurance company's job to provide that for someone. Eating right isn't rocket science, most is common sense. A balance of fat, protein, carbs, plenty of fresh veggies and fruit, a sensible amount of calories for your age, weight and activity level. Good luck!

Amanda great job and good fight! You rock out loud, girl!

I hate that insurance doesn't have enough money to cover stuff like this :(

That said, I really do agree that your goal should be to work out a healthier relationship with food. You CAN prepare it yourself, I know you can! It might take a lot of time with a counselor or a nutritionist but you will get there, and that's one more piece of the ED beaten.

If the insurance funded SS or other food delivery, in a way that enables you to avoid learning those skills and treating the ED. They'd be paying you to not get well. I think not only no way would they do it, but it's probably not a good idea in the long run.

Dietician? Counseling? Cooking classes? All GREAT and could be covered. But food handed to you? Not a healthy step.

By which I mean, not a healthy step long term or healthy from an insurance standpoint. If it is what is working for you right now, go with it!

Insurance companies don't see prevention as a smart business choice. I heard an insurance CEO once say, "Prevention doesn't work." Insurance companies are businesses. They have to turn a profit and most report on a quarterly basis. From that perspective, prevention has a small and slow payback vs. a surgery which is fast and the $ easily recoverable.

A person who has been smoking a pack a day for 40 years has lifted a cigarette to her lips 292,000 times.

How to gain 20 lb? Eat about 150 calories over your resting energy expenditure per day and don't exercise. You'd gain that weight in 466 days.

Improving/degrading health takes time & depends on the motivation of the smoker/eater. From the insurance company's perspective that's too long of a time frame and too much of a gamble given their profit model.

Realistically we can't expect much from insurance. Individuals and employers need to take the reins here.

http://recesswellness.com/wellness-your-personal-guide.php

shoo hal habal

I go to the doctor once a year for my yearly check up. This last year she told me to do everything exactly the same since I was in such good health. Shouldn't I be compensated that I don't burdent the health insurance system. Why am I paying for those who refuse to take care of themselves?

Here is what I know. My body has greatly suffered from years of bulimia back in the years before we knew what bulimia/anorexia does to us. I have now had open-heart surgery (disintegrated aortic valve) and a multitude of organs that, at one time, started eating themselves so, today, they aren't working right or doing for me what they should. Now, I am Diabetic as well and on Disability. What frustrates me is that I am allowed $25 per week, tops, for food. What is healthy that $25 can purchase for me to make it through a week to realize the good health I am supposed to be aiming for or that can heal my body? With this amount of funds for food, this only affords a diet that creates and maintains Diabetes. This makes no sense to me. Why would they want to create this situation ongoing, continuing to have to cover the ill health that innately goes along with this?

Just to verify, I have not been bulimic for several decades now -- now, I am struggling with Diabetes and the repercussions of the bulimia of long ago.