Settlement Expands Health Care Coverage for Eating Disorders

Horizon Blue Cross Expands Eating Disorder Coverage in Settlement

June 24, 2009 — Horizon Blue Cross of New Jersey has agreed to a class action settlement that expands medical benefits for patients with eating disorders. The settlement includes reimbursements of medical expenses for close to 500 patients whose payments for anorexia and bulimia treatments were denied.

As part of the settlement, the state of New Jersey requires Horizon to classify eating disorders as biologically based mental illnesses, resulting in eating disorders being covered the same way as other physical illnesses. Prior to the settlement, Horizon treated eating disorders (mainly anorexia and bulimia) as non-biologically based mental illnesses, limiting the benefits that patients received and making treatment prohibitively expensive.

The settlement could cause insurance carriers to reevaluate their views and policies on eating disorders to avoid future litigation. Horizon has agreed to give parity treatment for eating disorder claims and provided the right for patients to have their claims evaluated by an eating disorder specialist in the event their claim is denied.

Legal Help for Those Unfairly Refused Medical Treatment

Receiving proper medical care for an illness can be a complicated matter. The influence insurance companies have over medical treatment can make it difficult for patients to get the treatment they require for their ailments. You may need an attorney to enforce your legal rights if your insurance company rejects your medical claim. Brayton Purcell’s attorneys have the knowledge and resources to take on the health insurance industry. Please contact us with your legal questions if you have unfairly been denied medical benefits from your insurance company.