Any insurance that cover ADHD testing?

[Anonymous]

Our pediatrician recommended ADHD testing by a neuropsychologist. We have Aetna and I've been told by them that they do not cover any educational testing (which includes ADHD eval). It's about $3k-$4k for the evaluation. I'm wondering if this is worth switching insurance company for. Anyone have good experience with your insurance for ADHD eval and therapy coverage? Or is this pretty much the norm for all insurances?

[Anonymous]

We have United, they would not cover it either. We paid about 3K, but DID NOT LIKE our evaluator.
How about trying NIMH? There has been a lot of chatter on this forum on them lately, I wonder if they can do the evaluation.

How old is your child by the way?

[Anonymous]

Anonymous wrote:Our pediatrician recommended ADHD testing by a neuropsychologist. We have Aetna and I've been told by them that they do not cover any educational testing (which includes ADHD eval). It's about $3k-$4k for the evaluation. I'm wondering if this is worth switching insurance company for. Anyone have good experience with your insurance for ADHD eval and therapy coverage? Or is this pretty much the norm for all insurances?

Our testing was covered through insurance (under a different code), but I had to ask the tester to take out the ADHD code as my insurance did not cover that given it is considered educational testing. Not being clear here, it is possible, you just need to be creative. Do not say anything about ADHD when you ask, ask the tester for the codes that they will use and usually they are psych testing, when you call your insurance company...

[Anonymous]

Anonymous wrote:How old is your child by the way?

8 yrs old. Does age make a difference?

[Anonymous]

We had our son evaluated as part of an NIMH ADHD study. It's free, you get in very fast, they are doing the cutting edge research on ADHD - so they know their stuff, and it's not a treatment study - so there is no particular push for any type of treatment - just a lot of information that you can share with your pediatrician, school, etc. We had a wonderful experience.

http://intramural.nimh.nih.gov/chp/adhd/index.html

do a search on this forum. You'll find lots of post about people's experience in the study. Or just go to the website and give them a call.

[Anonymous]

We have BCBS and they cover testing for learning issues like dyslexia, ADD, but not educational issues, like getting an IQ test to appeal a GT denial.

[Anonymous]

OP - I was asking about age because many docs will push for expensive testing when the child is still too young. We did it at age 6 and wished that we had waited at least one more year. so much maturity happens during that time.

8yrs old is the perfect age to start testing. All will be fine. As I mentioned, try NIMH.

[Anonymous]

My BCBS covered testing that resulted in ADHD diagnosis (80% reimb).

[Anonymous]

Anonymous wrote:As I mentioned, try NIMH.

Definitely calling over there today. Thank you!! And thanks to those with the BCBS tip. This is why I love this board.

[Anonymous]

I wouldn't change insurance just for the sake of testing. What if there is a "pre-existing condition" clause? It may not allow you to test for a year. I could be wrong, but worth checking out.

Most, if not all, insurances will only pay for you to medicate anyway. Therapy of almost any kind is either provided by the school system or out of pocket.

[Anonymous]

Carefisrt covered part of Dr. Conlon's eval for ADHD. Out of network benefits. Maybe you could go that route?

[Anonymous]

We have Aetna and ours does cover the testing, but I think it is varies from employer to employer and what they are willing to cover/pay. That's why it is not universal.

Our Aetna plan won't pay anything out-of-network. We did have to find a psychologist who uses Aetna and was taking new patients. It was not easy to accomplish. A lot of phone calls, but eventually I found someone and it was very worth it. It saved us a lot of money.

[Anonymous]

Anonymous wrote:OP - I was asking about age because many docs will push for expensive testing when the child is still too young. We did it at age 6 and wished that we had waited at least one more year. so much maturity happens during that time.

8yrs old is the perfect age to start testing. All will be fine. As I mentioned, try NIMH.

What would you do if the school pushed for an evaluation at age 6 in first grade? Just wondering since I think this might be coming this year for my son who is 6. I personally don't think he has ADHD. He just seems very bright but very immature at the same time.

[Anonymous]

Anonymous wrote:What would you do if the school pushed for an evaluation at age 6 in first grade? Just wondering since I think this might be coming this year for my son who is 6. I personally don't think he has ADHD. He just seems very bright but very immature at the same time.

My experience with FCPS is that they are incredbily reluctant to suggest that a child needs testing. If they do, it's only after they've done a whole litany of interventions aimed at improving the structure, routine and supports for a child to improve. The regular classroom teacher has mulitple consultations with special ed teachers, psychologist and resource teachers to make sure she's doing all she can to provide appropriate support to the student.

Have you researched ADHD? We were stunned when our then 5 year old was diagnosed with ADHD. He was not hyperactive and had great concentration on the things he was interested in. After diagnosis and learning more about ADHD, it was crystal clear that he did but we really couldn't have known it until he was in more formal learning environment. If you think your DS has had good teachers and have been trying to work with him, I would allow them to test him.

[Anonymous]

19:30

Can you give the name of the tester who accepted Aetna?