How Much Does It Cost to Treat Eating Disorders, and How Can I Pay for It?

Eating disorders are serious mental health conditions that affect millions of people in the U.S. A Harvard University-based public health incubator called the Strategic Training Initiative for the Prevention of Eating Disorders (STRIPED) found that an estimated 28.8 million Americans who were alive in 2018-2019 would experience an eating disorder in their lifetimes. That means they’ve had an eating disorder, were dealing with one, or were expected to have one in the future.

Eating disorders can be fatal. An estimated 10,200 deaths annually are the result of eating disorders.

The good news is that there’s help available. Eating disorders often can be treated effectively. Treatment depends on the type of eating disorder, and cost depends on the level of treatment as well as its length and intensity.

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What qualifies as an eating disorder?

Eating disorders are behavioral conditions and medical illnesses in which persons have severe disturbances in eating and can have obsessions with weight, body image, and exercise. 

The most common eating disorders are:

• Anorexia nervosa, which is denying yourself food (starvation) and other behaviors such as vomiting and exhaustive exercise. These activities can lead to life-threatening weight loss. Symptoms can include obsessions about food as well as anxiety, irritability, and withdrawing from social situations.

• Bulimia, which is defined by binging on foods and then trying to lose calories gained by vomiting, using laxatives, or excessive exercise. Symptoms can include low self-esteem, feeling out of control, and shame about overeating.

• Binge-eating disorder, which is characterized by consuming large amounts of food in a very short period of time — even if you’re not hungry, or after you are full. Symptoms can include embarrassment, disgust about yourself, and depression.

Other eating disorders include:

• Pica, which is eating items that are not typically food, such as dirt, paint chips, hair, or ice.

• Rumination disorder, which is characterized by regurgitation of food that may be rechewed and swallowed again or spit out.

• Orthorexia, which is an obsession with “healthful” eating.

• Other specified feeding or eating disorder, which is a catchall diagnosis for those who do not meet strict criteria for anorexia or bulimia but still have a significant eating disorder.

What are common treatments for eating disorders?

The type of treatment you need for an eating disorder will depend on your diagnosis and level of care. Typically, aspects of treatment include:

• Psychotherapy, such as talk therapy or behavioral therapy.

• Nutritional counseling to address healthy eating choices as well as to increase awareness and support by relatives, caregivers, and friends.

• Medical monitoring, which may include a care team of professionals such as physicians, mental health professionals, dietitians, and even dental specialists.

• Medications, such as antidepressants and anxiety drugs.

Medicare, Medicare Advantage, and private insurers often only cover a portion of the treatment. Because eating disorders are mental health conditions, the treatment usually requires permission from the insurer called prior authorization as well as a continuing review of the interventions and costs.

Why is it so difficult to get treatment for anorexia and bulimia?

Recent U.S. laws require “mental health parity,” which means insurers can’t offer a lower level of coverage or higher copayments or coinsurance for mental health care than for physical or medical care.

But sometimes difficulty arises when the diagnosis doesn’t meet exact criteria for insurance coverage. For instance, coverage may be denied if your weight is not low enough for anorexia treatment or you have had no medical consequences from bulimia. You can advocate for coverage by writing a letter to the insurance company. The National Eating Disorders Association (NEDA) provides sample letters.

How much do these treatments cost?

Treatment for eating disorders can range from occasional visits to a therapist to an inpatient hospital stay. Costs vary, as well; hospital or residential facility stays are the most expensive. An inpatient hospital stay can last about 2 weeks and cost more than $19,000 total. A residential facility stay for intensive treatment averages 1 month at a cost of more than $1,200 per day. 

Outpatient care typically includes the individual cost of visits to physicians, therapists, and dietitians as well as therapy sessions and medications. If you have insurance, these costs can be covered. The facility may offer a payment plan.

One alternative to a hospital or residential facility is called intensive outpatient treatment. An intensive outpatient program can be your starting point for care or a step down from inpatient treatment or partial hospitalization. The program is usually attended for several hours a day while you continue to reside at home.

What are my insurance coverage and payment options for these treatments?

Medicare has different types of coverage for mental health treatment, which includes eating disorders. They are:

• Inpatient care, which includes hospital and residential treatment. This is Medicare Part A, which means you pay a deductible for each benefit period and 20% of the Medicare-approved amounts. There is also a daily coinsurance payment after the first 60 days of each benefit period. 

• Outpatient care, which includes psychiatric evaluation as well as group and individual psychotherapy. This is Medicare Part B, which means your out-of-pocket costs are 20% of the Medicare-approved amounts after paying your Part B deductible ($203 in 2021). Medicare Part B may also provide partial hospitalization and telehealth services for mental health care.

Medicare Advantage plans and private insurers also cover treatment for eating disorders. Most insurers will want to see a treatment plan to determine what they will pay. 

Whether you have Medicare, Medicare Advantage, or private insurance, once you are diagnosed, you also can ask the insurance company for a case manager, which may help expedite payment decisions.

Communicate with your insurer to determine whether the facility or provider can submit claims for your care, or if you will have to pay upfront for reimbursement. Your out-of-pocket expenses for eating disorder treatment fall under psychiatric care, which is reimbursable by flexible spending accounts (FSAs) and health savings accounts (HSAs).

Additionally, some employee assistance programs offer treatment for eating disorders, such as talk therapy with counselors. These are programs offered by employers to help employees with problems that may affect their work performance and personal well-being.

What if I don’t have insurance? 

If you are uninsured, some of your options for eating disorder treatment are:

• Community health centers, which include federal qualified health centers, may offer mental health counseling for free or on a sliding scale. Not all centers will have staff specifically trained in eating disorders, but they may be able to offer treatment or refer you to specialists who may agree to a discounted fee.

• Support groups are often led by patients but sometimes are conducted by mental health professionals. These groups can be in person or online and offer a place to connect with other people who are facing eating disorders. The National Eating Disorders Association (NEDA) maintains a searchable list of support groups by state.

• Research studies need participants. Joining a study could mean at least one form of treatment at no cost or at a reduced cost. NEDA maintains a searchable list of research studies by state.

• Charitable and nonprofit eating disorder organizations that offer scholarships for eating disorder treatment include Project HEAL, which offers financial assistance for those who cannot afford treatment costs. Also, if you are a member of a faith community or congregation, ask about help covering treatment costs.

• Paying on your own can be scary and expensive. If you are advised to enroll in an outpatient or residential treatment center, ask if they offer discounts or scholarships.

• Certified community behavioral health clinics are an emerging source of mental health counseling for the uninsured, underinsured, and veterans, among others, funded by the Substance Abuse and Mental Health Services Administration.

• For additional questions about how to access and pay for treatment, you can call the NEDA helpline at 800-931-2237.

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Written by:

Fran Kritz

Fran Kritz is a healthcare writer specializing in consumer and healthcare policy reporting. Previously, she has been on staff at Forbes, U.S. News and World Report and the Robert Wood Johnson Foundation.

Edited by:

Cindy George, MPH

Cindy George is the senior personal finance editor at GoodRx. She is an endlessly curious health journalist and digital storyteller.

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