The Battle to Save Lives: Eating Disorder. Gaps in Military Insurance

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1 The Battle to Save Lives: Eating Disorder Gaps in Military Insurance $910 a day. That was the figure we were provided for our daughter, Hannah, to receive treatment for her eating disorder in the outpatient setting where we live. We just finished four months of 24 hour a day inpatient treatment and this was the step down treatment that was adequate for her needs. As an active duty military family, I just knew Tricare would cover it. After all, it wasn t an optional treatment, it was life or death and I knew I didn t need to worry. We were part of the greatest military force in the world and this was not a condition that resulted because she wanted to be skinny. My new friend in our eating disorder support group told me how to define her illness to others- she didn t choose it and I didn t cause it. That summed it up. I also learned eating disorders do not go away after inpatient treatment. The average recovery period is 2-7 years and there are various levels of treatment that many patients need to go through before they are recovered. Hannah was so young, only 14 years old, and had an early diagnosis. I thought we were going to be okay. She was diagnosed while we were stationed in Germany. Her heart rate became so low, due her weight loss; they put us both on the next medevac plane leaving Landstuhl Medical Center and flew us directly to Walter Reed Hospital. I had no idea it would be a one way trip for us and that I wouldn t be with my husband again for almost a year. Research has determined eating disorders are most successfully treated in a multi-disciplinary setting which meant we would need a team with an individual therapist, family therapist, medical doctor, Psychiatrist and dietary team. She needed group counseling and classes. We found the multi-disciplinary treatment setting. But we also found that Tricare military insurance didn t cover her treatment. Tricare states that freestanding facilities for eating

2 disorders or any other psychiatric care are not covered.. The only facility that has a focused multi-disciplinary treatment plan in South Texas where we are stationed is a freestanding facility. Let me say that again. San Antonio, Texas is known as Military City USA and we don t have insurance coverage for out-patient eating disorder treatment. Without insurance coverage, we have had to pay for all of Hannah s treatment. My husband makes $59,000 annually as an enlisted Soldier. He has 19 years of service and we are so proud of him, so is his country. Because of our long-history serving our country I honestly thought I would be able to just educate those in Congress who could do something about the regulation, written all the way back in 1983, that resulted in Tricare not covering free standing facilities. that I could get Hannah s treatment covered. I thought that if they just understood that freestanding facilities are one of the generally accepted standards of treatment for patients with eating disorders, they would change the regulation and Hannah s treatment, and medical treatment for every other military member and family member who suffers most lethal of psychiatric illnesses, eating disorders, would be covered. So I became very busy researching the Federal Regulation that resulted in Tricare s inability to cover Hannahs treatment. I wrote to our Senators, Congressmen and I called every federal and state agency that could offer assistance. I spoke to 21 agencies in all. I discovered there was a chance, if I worked fast enough, to send an urgent plea just in time for consideration in the Defense Appropriations bill in November However, after relentless s, phone calls and unanswered messages, my contact at s office said we missed the boat and the bill was passed without any discussion of changing the CFR that impacted the way Tricare does or doesn t over benefit coverage for eating disorders. Senator Cornyn s and Congressman Lamar Smith s office responded the most often and sincerely, but unfortunately the federal regulation

3 governing Tricare, remains unchanged and still reads as it did back in 1983: A freestanding eating disorder program is not eligible for status as an authorized institutional provider of services and supplies. Ref 32CFR 199.4(g)(3) and (g)(28); 32 CFR 199.6(b) and (c), July 19, if they ask. In the meantime, we asked the outpatient facility to provide her the best care they could offer for $510 a day (do you mean that you asked them for a discounted rate and they agreed? If so, maybe spell that out a bit). And so we started paying. We used all our savings(?) money and borrowed $5000 from our other daughter; money she was supposed to use to live on during her second year of college. The treatment facility suggested we take a mortgage on our house or use college savings. That day, I walked out of the facility crying and feeling like a failure as a military parent for the first time in my life. You see, we don t own a home. We have moved 9 times in 19 years. We don t have college savings because our girls are bright and get scholarships. I have a Master s Degree in Religious Education and there are some jobs in that field but not often at each assignment. I worked as much as possible as a substitute teacher so I could earn money on the days we weren t at the treatment facility. The cost of paying for treatment weighed heavily on our family, every single day. Ultimately, Hannah made progress in treatment. She learned healthy coping skills, became healthier physically and mentally, and she found a new normal way of life. While her body healed physically, her mind became stronger and she now has a glimpse of what life without an eating disorder might be like.

4 As with most mental illnesses, it is hard to keep this shame filled illness secret. Hannah is now a 16 year old High School junior with hopes and dreams. Sadly, I made a grievous mistake of telling her about the financial burden of this care. I can picture her like Atlas -slight in frame with the weight of all of our financial futures, and her own health, pressing down on her shoulders. It s not about the money and it is about the money. She can t continue in treatment unless we find more money and there is no golden pot at the end of the rainbow. She shouldn t have to carry this burden, especially not while she is trying to recover and trying to get back to living a normal, healthy and productive life. Now, I am here with you. To get here, it took a leap of faith and courage. I started reading the blogs of others in attendance today preparing for this moment. Some have daughters that died! I have slammed down my computer countless times after reading about their brokenness and fallen to my knees. I am so scared that I will be back in front of you in 3 years. That is when she goes off to college and then the disease might come back with a fury that ravages her body and mind again. The voice of ed will scream in her mind and no one will be there to help her and she will be alone. It keeps me up at night and I can t even write this speech without crying and praying it won t happen. My biggest fear with my other two daughters in college was experimentation with alcohol, and at worst, sexual assault. With Hannah, I pray she eats. But I know if my girls are alive, we can recover from anything. We are Army Strong! I just worry that if she needs treatment again, we will not be able to pay for it and what then? Military members are often called heroes, rightly so. But today you and your bosses can be heroes to us by listening to our stories, my daughter s story, and by standing up to be a champion who will help us pass legislation that addresses eating disorders, including updating one outdated word in a federal regulation. Thank you.

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