ADHD Insurance Coverage FAQ

Is ADHD Covered By Insurance?

Unfortunately, the answer depends on your specific insurance. However, the majority of plans will cover ADHD prescriptions for children. It is a little less uniform whether an insurance plan covers ADD for adults.

It is much less common, although not rare, for medical insurance to cover counseling or therapy for ADHD for adults or children. Typically, ADHD is not singled out, meaning that it follows the same coverage rules as all other “mental health” or “counseling” services. Your first step for verifying your insurance policy coverage rules for ADHD is to check the general mental health services rules, and then move on to specifics from there.

Adderall Prescription Coverage Insurance Rules

It seems that some insurance policies single out Adderall, and the Adderall generic equivalent, mixed-amphetamine salts when it comes to prescription drug coverage. Because Adderall can be used “off-label” for weight-loss and many insurance policies do not provide coverage for weight-loss treatment Adderall is sometimes excluded from coverage or subject to more stringent prescription benefit rules.

It is odd that just because Adderall causes weight loss in some people that an insurance policy would deny all coverage to anyone who uses it for legitimate purposes. However, until someone comes up with meaningful health care reform that allows people to vote with their feet and leave insurance plans with dumb rules, there isn’t much anyone can do. However, some insurance policies offer an appeals process which may be used to attempt to get coverage for Adderall or generic Adderall reinstated.

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