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Parents of ADHD Children

ADHD Testing - Insurance coverage

My wife and I struggled with our daughter during High School since she was bright but couldn’t seem to focus and stay on task.  During her freshman year in college, with the increased work load, it became apparent that she could no longer use her other skills to overcome the issues she had.

Before prescribing medication, her pediatrician recommended that she get tested for ADHD.  The testing took most of a day and resulted in a diagnosis of ADHD and a recommendation that she take medication and seek accommodation from her college.

The issue I have is with the lack of insurance coverage for the ADHD testing itself.  The insurance company will pay for medication (which is good), time with the pediatrician (also good), therapy if she needed it (she doesn’t), but wouldn’t pay for the testing to determine her condition. Since we wanted a diagnosis before beginning treatment we paid for the test out-of-pocket.  Any suggestions on how to appeal the insurance denial?


What insurance do you have and what state do you live in?

Posted by cheroyley on Jul 17, 2014 at 6:22pm

I have never been able to get that sort of thing covered either.  Good luck!

Posted by Pdxlaura on Jul 18, 2014 at 8:01pm

We have had my son tested twice, once to diagnose and once as a follow up. Both times, our insurance company did not cover the eval. So, I can tell you, it will probably cost you right around $1000 for a standard eval with testing. If you just take her to a psychiatrist and get them to prescribe meds, it will cost between $150 and $300.

The only advantage to getting a formal diagnosis is that she may qualify for more services and help in college if she has documentation of a formal diagnosis. If she has that, she can take it straight to disability services at her college or university. This should qualify her for classroom accommodations and supports such as tutoring. Her college or university cannot offer her these services unless she asks for them and has a formal diagnosis because they cannot ask her if she has a diagnosis. Its a violation of her right to privacy if they do. That how it works at the college where I teach.

Here is another suggestion. If your daughter attends a large university, she might be able to go to the psych dept. and have the testing done for free. There may also be a large university near you with a psych dept. You can contact them as well. These department will sometimes offer evals at no or reduced cost as well.

Hope this information is helpful to you.
Sue H in PC, Ohio

Posted by SueH on Jul 19, 2014 at 6:25pm

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