Insurance and ADHD

iVillage Member
Registered: 06-12-2003
Insurance and ADHD
9
Tue, 06-16-2009 - 11:50am

My family has applied for a new health insurance policy this past month and my 8 yr old son was denied any health coverage through United because he has ADHD. This is sooo frustrating. He only sees the doctor twice a year for weight checks. There is no ongoing therapy or anything that would cost the insurance any amount of money. We pay for his meds out of pocket since we have a high deductible plan. I really wish I had known this diagnosis was going to cause these kinds of problems. His ADHD is mild and I wish I had tried other methods of management before getting him diagnosed.

Has anyone else run into a problem like this?

Thanks!

Avatar for kathyjoenathan
iVillage Member
Registered: 06-04-2003
Tue, 06-16-2009 - 12:18pm

That's AWFUL!

Kathy

iVillage Member
Registered: 06-10-2007
Tue, 06-16-2009 - 1:34pm

HI, it sounds familiar to me.


A child may HAVE ADHD, but it is not what they ARE. Never tell a child they ARE ADHD.

Avatar for claddagh49
iVillage Member
Registered: 07-20-2004
Tue, 06-16-2009 - 2:29pm

My grandson is on CHIP because my son doesn't make much money. Frankly, I despise Ins companies. I wish we could get a single payer or some HealthCare reform! We really need it. We are the only country that puts up with this crap. It's corporate greed. I would rather pay what my DH pays in coverage from his employer 4,500 a year, plus 1,000 out of pocket expense before they pay hardly anything in tax or something, rather than know somw greedy CEO is sitting on his duff in a 5,000 suit.


My son was eligible for the Free CHIP for my grandson.

iVillage Member
Registered: 03-25-2008
Tue, 06-16-2009 - 2:44pm

Private health insurance companies are all the same. They will turn you down for anything, and I mean anything. My husband disclosed that he smoked as a teenager and he was turned down because of that ... 20+ years later! I was turned down for having an eye condition that requires nothing but annual eye exams.

iVillage Member
Registered: 10-09-2004
Tue, 06-16-2009 - 5:56pm
We had an insurance co turn down paying for the ADHD meds and counseling since it was a pre-exisiting condition, but not outright deny coverage.
iVillage Member
Registered: 06-12-2003
Tue, 06-16-2009 - 8:49pm

Thank you all for your replies. I am just so surprised that they would turn him down for ALL coverage. I can understand them not covering his ADHD related expenses, I guess. I just have mommy guilt about having him "labeled" and now this.

We do not qualify for medicaid, based on income, from what I initially looked at. We have applied to another insurance company and they said they would cover him, but not his ADHD expenses. Who knows for sure what will happen once underwriting goes through it all.

It's all so crazy. Turning down kids for health care coverage... insurance companies are mean!!!

Thanks again!

Avatar for kathyjoenathan
iVillage Member
Registered: 06-04-2003
Tue, 06-16-2009 - 9:37pm

You should further investigate Medicaid because ADHD is a disability and that alone qualifies HIM for the coverage; income does NOT matter - My sister in law is a Medicaid Services Coordinator.


Maybe asking one of your sons specialist about the medicaid, they may have answers, if not...keep looking because I KNOW your son would qualify, the rest of the family won't but he will.


If you have insurance, the Medicaid would be the secondary insurance so they will cover

Kathy

iVillage Member
Registered: 06-10-2007
Tue, 06-16-2009 - 11:07pm

There is a program available for kids who are not eligible for Medicaid, but in my state(TX) there is an 8 year waiting list, and then they are only eligible if they have a trach or GTube.


Medicaid has changed, and ADHD does not guarantee eligibilty. I have tried every avenue for coverage, and it is just not available for some of us.

A child may HAVE ADHD, but it is not what they ARE. Never tell a child they ARE ADHD.

iVillage Member
Registered: 02-19-2008
Wed, 06-17-2009 - 9:01am

My son had insurance prior to diagnosis. However, we later attempted to increase his annual drug coverage and were denied due to his pre-existing condition.

Have you checked with your state insurance commissioner regarding action you can take due to denial of insurance?