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ADHD Insurance

If you are having trouble getting your insurance company to pay for treatment for a mental disorder such as ADHD, you aren't alone. When managed care organizations came on to the scene about ten years ago, they did so with the mission to cut costs wherever they could, and some do so by denying even legitimate claims. That practice led to widespread consumer outrage, and it also led the establishment of independently-run review panels in many states. Also, insurance companies are required to have an in-house review board, whose decisions can supersede those of the company itself. Most consumers looking for ADHD insurance don't realize that these review boards are even there, or how they can help them save money on treatment. Too many times, a person's claim is denied and they just give up, and many of us don't have the time or the knowledge to pursue it any further.

If winning an appeal means saving quite a bit of your hard-earned money on your ADHD insurance and treatment, taking the time to mount an appeal to the insurance company's decision can really pay off, and quickly in most cases. According to the Kaiser Family Foundation, just over half (52%) of patients won their first appeal. If it gets turned down, keep going, because the study also found that those who resorted to a second appeal prevailed in 44% of cases, and those who lodged a third appeal won in 45% of cases. Those are pretty good odds, especially when fighting against a bureaucracy like an ADHD insurance company.

Benefits for ADHD treatment and other mental issues are very tricky to navigate, because most insurers have an upper limit on how much money they will pay out over the course of a year, or the number of doctor visits they will pay for. However, there's some wiggle room when you can prove that your ADHD diagnosis or that of one of your dependents requires more care than the policy allows for. To find out how much flexibility is within your ADHD insurance policy, read it carefully to see what mental health benefits you are eligible for.

You should also know your local and state laws; contact the Mental Health Association in your state to find out your state's laws regarding reimbursement for mental issues. Be prepared to provide written documentation of your condition, because some insurance companies do not consider ADHD as a "severe" diagnosis. However, the disorder can have different degrees, and can actually be quite serious. In these cases, you will need written proof to assist in validating your services. If you need to, get a letter of medical necessity, and save test results showing your need for certain services.

Above all else, keep good records every time you deal with your ADHD insurance company. Keep in mind, they are a bureaucracy, and there's a lot of red tape to cut through. Write down the name and number of every person you speak to, and the date the conversation took place. You should also keep a running record of what the conversations entailed. It may seem tedious to do so, but keeping records and lodging repeated appeals if necessary will increase your chances of successfully getting coverage for ADHD treatment.