Does BlueCross BlueShield cover eating disorders?

BlueCross BlueShield is one of the largest health insurers in the country, made up of local Blue plans like BCBS of Texas, Florida Blue, and Anthem Blue Cross. Whichever Blue plan your card belongs to, it generally covers eating disorder treatment that is medically necessary, the way it covers other medical care. This page explains how that coverage usually works and how to verify your benefits.

Does BlueCross BlueShield cover eating disorder treatment?

Generally, yes. A Blue plan covers eating disorder treatment that is medically necessary, and federal mental health parity law requires behavioral health, including eating disorders, to be covered no more restrictively than comparable medical care.¹² The 21st Century Cures Act of 2016 confirmed that eating disorder benefits, including residential treatment, are protected under parity.³ Your plan sets the cost-share and authorization rules, which a program can verify for you.

What to know about BlueCross BlueShield for eating disorder treatment

• It covers the full continuum when each level is medically necessary, from outpatient up to inpatient care.
• Medical necessity determines approval, and the higher levels require pre-authorization, reviewed against standards of care for eating disorder treatment.⁴ For ACA-compliant Blue plans, mental health and substance use services are required essential health benefits.⁵
• BlueCard travels with you. A program in-network with its local Blue plan is generally in-network for any BlueCross BlueShield member, even in another state. The exception is a plan that manages mental health benefits through a separate company.

Levels of care

When treatment is medically necessary, a Blue plan can cover outpatient, intensive outpatient, partial hospitalization, residential, and inpatient or medical stabilization. The higher levels require pre-authorization, which the program handles as part of admission.

Verifying your BlueCross BlueShield benefits

The reliable answer comes from your own plan. Call the number here and a licensed eating disorder program will verify your BlueCross BlueShield coverage, your cost-share, and the authorization rules. The general process of authorization, cost-sharing, and appeals is in verifying your insurance.

Finding a program that accepts your Blue plan

Because a program in-network with its Blue plan generally works for any BlueCross BlueShield member through BlueCard, a clinically appropriate program is usually available, even in another state. Search the directory and call to speak with a licensed eating disorder facility. EDrehab contracts with no Blue plan; the licensed eating disorder programs we connect you with bill them directly.