I am in the process of looking for a better health insurance policy for myself and my adolescent ADHD son. I tried one company, but when I was interviewed by them I honestly told them about his treatment (1 prescription and approx. 6 brief checkups with his psychiatrist for monitoring per year) we were refused. When I appealed the decision, asking them to exclude the condition, they again refused, saying they didn’t have that exclusion rider.
Anyone else have any ideas/suggestions?
Re: Health Insurance
Just want to share that some large HMO’s tend to limit their treatment of ADHD often redefining aspects of ADHD as a learning disability so they can escape coverage costs - basically they claim they provide health insurance but in reality the fine print tends to intentionally take that coverage away/aspects of that coverage away for lifelong neurological conditions like ADHD. It is more common than the advertisements on tv for HMO coverage suggests and it is done simply as a cost saving method by the HMO. In the world of business it is often called bait and switch/bait and deny.
Thank you for sharing that your insurance coverage tended to basically wink at what is believed to be one of the most common childhood health needs - ADHD - and then wink again and deny good coverage for ADHD. It’s a shame in my view that this is happening in America today, year 2001.
This sounds bizarre since you are dealing with a bonafide medical condition outlined in DSM IV etc. etc. ARe you looking at self-pay or through your employer? If through employer you should work with the HR people there, since this is ridiculous and discriminatory. If on your own you might consult a lawyer. Also try contact CHADD (national ADHD group, links will be on this website) — they probably have info that can help you with this.