A Whole New Battle

Dawn and Bart Beye did everything by the book. When their teenage daughter began showing signs of a serious eating disorder, they caught on fast—confronting the illness in its early stages. When their child got progressively worse, they enrolled her in a full-time treatment program they thought was covered by insurance. But three weeks into their daughter’s treatment for anorexia—which experts say can take months—the Wayne, N.J., couple was told their insurance provider, Horizon Blue Cross Blue Shield of New Jersey, would no longer pay for treatment.

More than six months later, as their 16-year-old (whose name is not being identified at the family’s request) remains in a private recovery facility, the Beyes have spent tens of thousands for her treatment out-of-pocket. They’ve taken out home-equity loans, tapped every savings account—even depleted their childrens’ college funds. And on top of it all, Dawn, a special-education teacher, is out of work due to her own health: she found out in September that she had a benign brain tumor that had to be removed. “Here I am, left with close to $200,000 in medical bills, my daughter still needing treatment, every asset we have at risk, and the stress and emotions are off the chart,” she says. “Now my daughter, who wants to get better, wants to know if we can keep her [in treatment]. We told her, ‘We may not have the same house when you come home—but it’s only a home.’ The most important thing is that she gets the treatment she needs.”

Fighting Back: Beye is suing her insurance company for not fully covering her daughter's eating disorder

Though eating disorders affect some 11 million people in the United States, according to the National Eating Disorders Association, only 11 states have laws explicitly mandating that insurers cover their treatment. Thirty-four states require general mental health coverage, though insurance companies have a lot of leeway in how they define "mental disorders” and some may not cover anorexia or bulimia. The result is many families sinking into medical debt. “Wherever I go, I hear the same stories—families depleting their retirement accounts, going through life savings, taking second mortgages on their homes because insurance companies won’t pay for their child’s coverage,” says Lynn Grefe, head of the National Eating Disorders Association, a Seattle-based advocacy group. “I don’t think I can think of a state where I don’t hear these stories, and families just don’t know how to get out of this hole.”

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That denial of coverage is why Dawn Beye, with the help of a vast team of medical and legal experts, filed a class-action lawsuit Nov. 8 against Horizon Blue Cross on behalf of the residents of New Jersey, New York and Pennsylvania—maintaining that her daughter’s and other similarly situated patients' illnesses are “biologically based” and should be covered under the laws of all three states. The company disagrees, saying anorexia is a product of one’s environment rather than genes—and therefore not covered by the state laws. At stake, says Beye, are lives—as more than 10 percent of the nation’s 8 million anorexics will die from their disease, according to the National Eating Disorder Association.