Insurance Declined?

[Angkay01]

Hello!

Both my boys have recently diagnosed ADHD and one of them also has DMDD. Our insurance covered the testing and diagnosis, but not the treatment (medicine or OT).

Does anyone have suggestions for a secondary coverage or advice? I apologize if this has already been asked. Thank you in advance.

[Onthemove1971]

How horriable.. did they say why? I would ask your Pediatrician to help you appeal the decision. While the school can not give medication ( hard to believe if his doctor says he needs it they would say no) but the school maybe able to give him OT.

[ADHD_DAD]

Can you please provide more information? If so, I'll try to help. Please provide name of insurer (I am guessing UnitedHealth based on posts of others) and the recommended treatment. For example, is it meds (which should be covered) or counseling (which CAN be covered, but you have to jump through the proper hoops)? Thanks

[eeyore13]

We have to fight the insurance company (BlueCross) just about every year on both my son's and my husband's meds(both are generic as they refuse to cover name brand). Usually, it is because they do not want to pay after we meet the deductible, but it has also been because the insurance doctors have decided that my husband should not be on the dose that he has taken for 35+ years. Fortunately, my husband's psychiatrist was able to find a workaround to get him the amount he needs.

Our pharmacist was very helpful in that she gave us her number for the insurance company and the matter has never taken more than a few days to resolve after that.