Woman battling multiple health issues refuses to take 'No' from her insurer

October 11, 2013 by Serena Gordon, Healthday Reporter
Woman battling multiple health issues refuses to take 'No' from her insurer
Quinn Nystrom of Minnesota said residential treatment saved her life.

(HealthDay)—In May 2012, Quinn Nystrom made a decision to get well. She'd been battling an eating disorder, post-traumatic stress disorder, anxiety and depression, as well as trying to maintain good control of her type 1 diabetes. But she'd had some form of eating disorder—both anorexia and bulimia—since she was 12 years old. At 26, the Baxter, Minn., resident had been in treatment for two years and still struggled every day to try to eat normally. Most days, though, her eating disorder won.

But that May, a friend who'd been in with her, and who also had , died.

"At her funeral, I thought, 'This can't be me.' I had to stop the chaos and not give everything up," Nystrom said.

"I knew I didn't want to half-ass it," she added. "I wanted to go to a place that could give me the best chance of getting better."

Nystrom found a treatment center that boasted good success for people who have co-existing disorders. Having type 1 diabetes made this more complicated because her treatment, and her life generally, would always have to include a focus on food because of her diabetes. She has to take insulin to survive, and it's important to match the amount of insulin to the food she eats to prevent dangerously high or low blood sugars.

When she was evaluated at the new treatment center, it was recommended that she enter a residential treatment program for three to four months. Nystrom said that level of care was suggested because she'd already tried a partial-day program that had failed to stop her disordered eating. In addition, because she had co-existing mental health issues, the treating physician thought that residential treatment would be the best way to tackle everything at once and set Nystrom on the road to recovery.

Her insurance company, which until this point hadn't balked at paying for treatment, refused to pay for the residential program. She appealed the decision three times, but each appeal was denied.

One appeal reviewer said that Nystrom was seeking BMW-level care when she really just needed Honda-level care, according to court records.

However, the insurer was willing to continue covering Nystrom's treatment through the partial-day program, even though she'd tried that for two years with no success. So, while the appeals were ongoing, Nystrom entered a residential treatment program—at a cost of $45,000 total. Her parents sold some of their possessions to pay for their daughter's treatment.

The biggest irony, according to Nystrom, is that the partial-day program that the insurance company wanted her to go to would have cost more than the residential treatment she received.

She's now suing her to try to recoup the money her parents invested in her recovery. "This case is for the principle," she said. "I'm hoping it will give other young women and men the confidence to challenge their insurance companies."

"If this had been about my type 1 , and I was at the hospital, there wouldn't be a question," Nystrom noted. "Why is mental health looked at as something they can decide yay or nay to? Why is there a doctor, who has never spoken to me or seen me, allowed to give a thumbs up or down to my treatment?"

Whether changes in health coverage brought about by the Affordable Care Act will keep others from following the same path as Nystrom remains to be seen. At least some residential services are included as essential health benefits that most insurance plans will have to offer under the new law, according to Mental Health America. Health and legal experts generally agree, though, that at this stage in implementation of the law, the details remain sketchy.

But no matter the outcome of Nystrom's lawsuit, her own story has a happy ending on the personal side.

Residential treatment "saved my life," she said. "It was the best treatment place I could've gone. Life is great in recovery. I'm in graduate school now, and I'm working on a book. I wouldn't have been able to do that before. I'm in the best place I've been in a really long time because I got the treatment I knew I needed."

Explore further: Hunger pains: Binge-eating disorder linked to lifelong impairments in 12-country study

More information: Read this HealthDay story on how the Affordable Care Care may benefit people with mental health issues.

Related Stories

Hunger pains: Binge-eating disorder linked to lifelong impairments in 12-country study

September 23, 2013
Binge-eating disorder, designated only months ago by the American Psychiatric Association as a diagnosis in its Diagnostic and Statistical Manual of Mental Disorders, is associated with substantial lifelong impairments comparable ...

Mental health and substance use disorder benefits expanded

February 22, 2013
(HealthDay)—In a final rule, which will make purchasing health coverage easier for consumers, mental health and substance use benefits will be expanded to 62 million Americans, according to a report published Feb. 20 by ...

Young risk-Takers drawn to dangerous 'Choking game'

April 16, 2012
(HealthDay) -- In a new study, about 6 percent of eighth graders admitted they had participated in the "choking game," in which blood and oxygen to the brain are cut off with a rope or belt to produce a euphoric "high."

The incidence of eating disorders is increasing in the UK

May 20, 2013
More people are being diagnosed with eating disorders every year and the most common type is not either of the two most well known—bulimia or anorexia—but eating disorders not otherwise specified (eating disorders that ...

Cancer survivors not receiving preventive care

August 7, 2013
While cancer survivors require follow-up care to prevent a recurrence of their cancer and to watch for after effects of treatment, they also need the same preventive check-ups suggested for all people.

Recommended for you

Sugar not so sweet for mental health

July 27, 2017
Sugar may be bad not only for your teeth and your waistline, but also your mental health, claimed a study Thursday that was met with scepticism by other experts.

Could insufficient sleep be adding centimeters to your waistline?

July 27, 2017
Adults in the UK who have poor sleep patterns are more likely to be overweight and obese and have poorer metabolic health, according to a new study.

Vitamin E-deficient embryos are cognitively impaired even after diet improves

July 27, 2017
Zebrafish deficient in vitamin E produce offspring beset by behavioral impairment and metabolic problems, new research at Oregon State University shows.

The role of dosage in assessing risk of hormone therapy for menopause

July 27, 2017
When it comes to assessing the risk of estrogen therapy for menopause, how the therapy is delivered—taking a pill versus wearing a patch on one's skin—doesn't affect risk or benefit, researchers at UCLA and elsewhere ...

Blowing smoke? E-cigarettes might help smokers quit

July 26, 2017
People who used e-cigarettes were more likely to kick the habit than those who didn't, a new study found.

Brain disease seen in most football players in large report

July 25, 2017
Research on 202 former football players found evidence of a brain disease linked to repeated head blows in nearly all of them, from athletes in the National Football League, college and even high school.

1 comment

Adjust slider to filter visible comments by rank

Display comments: newest first

1 / 5 (7) Oct 11, 2013
Wait till she is on Obama care.... her health insurance premiums will rise, her out of pocket payments will rise, and she'll have no one to sue.

But give that there are death panel's maybe she doesn't need to worry much longer either.

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.