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What's insurance coverage like for ADHD treatments?

Do all health insurance companies cover ADHD medications? What about behavior management programs?
Submitted by Team

Insurance coverage for ADHD drugs and therapy programs is inconsistent at best. Although many companies do cover ADHD medications, some require them to be prescribed only by a psychiatrist (which means you'll need to get a referral in order for insurance to pay). Many companies won't pay for behavioral therapy programs and the ones that do tend to limit the number of sessions covered. Bottom line, you need to know your insurance company and exactly what their policies are. If you're having trouble dealing with your insurance company you can always contact your state insurance commissioner for help. It's also a good idea to speak with your employer's insurance plan purchaser, who will be able to better explain your coverage and keep you from wasting time on the phone. Recently Congress passed a bill that stipulates that mental health coverage must be on par with other medical conditions, so if your company still has restrictive policies, you may want to submit a complaint to the company and to your state's insurance commissioner.

Copyright 2009

The answers from our experts are for educational purposes only. Please always refer to your child's pediatrician and mental health expert for more in-depth advice.

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Thankfully, our insurance covers my son's visits to the psychiatrist, so I only pay the regular $30 copay. Medication wise, we had to try a stimulant medication before the insurance would pay for the non-stimulant medication that was working for him. I was highly upset about that because I did NOT want to use a stimulant unless it was the last resort. But, in the end, it all worked out. A lot of medications offer discount cards too. I only pay $20 for one prescription and $10 for the other.
Submitted by RockinMomNTexas