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Does United Healthcare Cover ADHD Testing & Treatment?

Does United Healthcare Cover ADHD Testing & Treatment?

Does United Healthcare Cover ADHD Testing & Treatment?

Yes, United Healthcare insurance covers attention deficit hyperactivity disorder (ADHD) testing and treatment in Tennessee.

A complete medical evaluation is required to properly diagnose ADHD and rule out any potential other medical explanations for the symptoms.1

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How to Verify United Healthcare ADHD Coverage

Athena Care is in-network with most major insurance plans. Filling out our free, no-obligation online insurance verification form is the best method to determine if your United Healthcare ADHD coverage includes ADHD testing and treatment in Tennessee.

Let our highly experienced, expert care coordinators handle the difficulties of contacting your insurance carrier for more information about United Healthcare ADHD testing and treatment. A care coordinator will review your policy and thoroughly explain your options after you’ve completed the form. Rest assured, all submitted or discussed information is quick, easy, and confidential.

What is ADHD?

Attention deficit hyperactivity disorder, or ADHD, is a common neurobehavioral disorder characterized by persistent problems with executive processes such as attention, memory, organization, motivation, impulsivity, hyperactivity, time management, social skills, and other functions. These issues can start in childhood and continue for a lifetime, resulting in unstable relationships, poor school or work performance, low self-esteem, and other difficulties.

Signs & Symptoms of ADHD

The following are signs of ADHD that may present themselves in childhood: 

  • Daydream, seem lost in thought 
  • Forget or lose things 
  • Squirm or fidget, have trouble sitting at the dinner table or school 
  • Talk too much 
  • Make careless mistakes 
  • Take unnecessary risks, act before thinking 
  • Have a hard time resisting temptation 
  • Have trouble taking turns, blurt out answers, or frequently interrupt others 
  • Have difficulty getting along with others
  • Take longer to perform tasks or hurry through them
  • Have low self-esteem 

For adults with ADHD, symptoms typically begin in childhood and don’t disappear. However, if symptoms start after childhood, other diagnoses may be considered. In addition, adults with ADHD often don’t know they have it – they just know that everyday tasks seem more challenging for them than for most people. The following are potential signs of ADHD in adults:

  • Feeling like life is an endless race to keep up with work, family, and social responsibilities, as unfinished projects, chores, and paperwork pile up around them.  
  • Overlooking essential details, getting derailed by distractions, losing track of time, and missing deadlines.  
  • Experiencing quick, intense emotions and becoming highly agitated when waiting in line or driving in traffic. 
  • Feeling like they perform consistently below their potential and assuming that their issues result from laziness, lack of willpower, or poor self-control. 

Is ADHD Testing Covered by United Healthcare?

United Healthcare ADHD testing is most likely covered depending on your specific insurance plan’s benefits. Neuropsychological testing is medically essential for screening people with ADHD when the results are used to support a diagnosis, prognosis, or treatment plan.2 In addition, when the requirements of the Diagnostic and Statistical Manual of Mental Health Disorders, Fifth Edition (DSM- 5)3 are met, services for the treatment of ADHD are considered medically required.

Unfortunately, there are no specific tests that diagnose ADHD. Instead, diagnosing ADHD requires the evidence based4 results of the patient’s history, a physical examination, and patient/family interviews.

Some of the most well-known diagnostic procedures for assessing ADHD are listed below in more detail:

  • An interview with the parent and the child (to rule out other psychiatric or environmental causes of symptoms)
  • A medical examination includes a thorough medical history and a physical exam (to check for coexisting conditions). Oppositional defiant disorder, conduct disorder, depression, anxiety disorder, and learning difficulties are common coexisting psychiatric and developmental disorders in children diagnosed with ADHD.
  • An electroencephalogram (EEG) or a neurological consult if focused signs or clinical findings point to a seizure disorder or a degenerative neurological condition.

Many professionals are available to diagnose and treat ADHD. Examples include child psychiatrists, family physicians, pediatricians, psychiatrists, and neurologists, and treating ADHD can consist of individual or family psychotherapy.

When ADHD is left untreated, it affects relationships, quality of life, productivity, and mental health. Furthermore, it’s linked to a host of adverse outcomes, including:

  • Underachievement in school and at work
  • Self-esteem issues
  • Substance use disorders
  • Employment issues
  • Increased rates of divorce
  • Increased rates of depression and anxiety

Are ADHD Treatments & Medications Covered by United Healthcare?

Yes. United Healthcare ADHD medications are covered by insurance.5

The American Academy of Pediatrics (AAP) recommends both medication and behavioral therapy for children with ADHD.6 Following the administration of medications, patients should be closely monitored, and medicine should be taken consistently. Then, the doctor can check to see if the patient is receiving the correct dose.

After a few weeks on the medication, the side effects usually fade. Alternatively, the dosage might be reduced to minimize side effects.

United Healthcare ADHD medication coverage may include:

  • Stimulants
    • Stimulant medications, like Adderall or Ritalin, are commonly used to treat ADHD. These medications and their generic alternatives work for people of all ages to alleviate symptoms. Behavioral changes are usually rapid and significant.
  • Non-Stimulants
    • If stimulant medications cause unpleasant side effects or are ineffective, a doctor may prescribe a non-stimulant medication, like Strattera. These can be taken on their own or in combination with stimulants.
  • Complementary or Alternative Medicines
    • Some therapists and other health professionals use complementary or alternative medicines as treatment options. Certain alternative medicines and therapies, like acupuncture, may be covered depending on the United Healthcare plan you have.

How To Find United Healthcare ADHD Testing & Treatment Clinics Near Me?

With Athena Care, gaining access to ADHD testing clinics in Tennessee and access to behavioral health care has never been easier. Allow one of our care coordinators to assist you with any questions or concerns about United Healthcare ADHD testing and treatment coverage at one of various Tennessee locations.

Athena Care health clinics are open Monday through Friday, 7:00 a.m. to 6:00 p.m.

When choosing United Healthcare ADHD doctors, it’s important to ask questions and to keep the following in mind:

  • Education, training, license, and years of experience
  • Specialties and services offered
  • Treatment methods and philosophies
  • Insurance companies they work with
  • Office hours
  • Pricing
  • Session length

Here, you’ll find a list of practitioners organized by city, as well as information about their backgrounds and specialties.

How Much Does ADHD Testing & Treatment Cost Without Insurance?

The following are average costs for therapy, though they may differ by location and other variables. Therefore, they may not reflect the actual cost of treatment or what you may pay in Tennessee.

Doctor’s visits alone can range from a few hundred dollars to more than $2,700, and the cost of medication can go anywhere from $8 to $288 per month. For example, a month’s supply of widely prescribed generic stimulants costs around $187.97.7

In the United States, the typical cost of psychotherapy ranges from $100 to $2008 a session, dependent upon the state and the length of the session.

In addition, cognitive behavioral therapy (CBT) sessions can cost between $100 and $200 per session, while dialectical behavior therapy (DBT) usually consists of a weekly individual therapy session, a weekly group therapy session, and weekly phone conversations. DBT costs vary depending on the type of services rendered.

Telehealth treatment for ADHD patients is also beneficial. Telehealth sessions for the treatment of ADHD can range from anywhere from $150 – $200, depending upon the state’s treatment options and whether or not your United Healthcare insurance is accepted.9

Sources

  1. “Diagnosis and Treatment of ADHD.” United HealthCare, 2020, https://www.uhcprovider.com/en/resource-library/news/2020-network-bulletin-featured-articles/1120-adhd-resources.html
  2. “Neuropsychological Testing Under the Medical Benefit (for Tennessee Only).” United HealthCare Services, Inc., 2022, https://www.uhcprovider.com/content/dam/provider/docs/public/policies/medicaid-comm-plan/tn/neuropsychological-testing-under-medical-benefit-tn-cs.pdf
  3. “DSM-5® Diagnostic Criteria.” Takeda Pharmaceutical Company Limited, 2019, https://www.qandadhd.com/diagnostic-criteria
  4. Pelham WE Jr, Fabiano GA, Massetti GM. Evidence-based assessment of attention deficit hyperactivity disorder in children and adolescents. J Clin Child Adolesc Psychol. 2005 Sep;34(3):449-76. doi: 10.1207/s15374424jccp3403_5. PMID: 16026214. https://pubmed.ncbi.nlm.nih.gov/16026214/
  5. “Pharmacy Benefit Coverage Updates.” United HealthCare Services, Inc., 2022, https://www.uhcprovider.com/content/dam/provider/docs/public/resources/pharmacy/Pharm-Benefit-Update-May2022.pdf
  6. “ADHD Treatment Recommendations.” U.S. Department of Health & Human Services, 2021, https://www.cdc.gov/ncbddd/adhd/guidelines.html
  7. “The Costs of Childhood ADHD.” WebMD LLC, 2022, https://www.webmd.com/add-adhd/costs-childhood-adhd
  8. Lauretta, Ashley. “How Much Does Therapy Cost?” edited by Alena Hall, Forbes Health, 2021, https://www.forbes.com/health/mind/how-much-does-therapy-cost/
  9. Rendall, Jessica. “Getting an ADHD diagnosis has gotten easier online. Is that a good thing?” CNet, 2022, https://www.cnet.com/health/medical/getting-an-adhd-diagnosis-has-gotten-easier-online-is-that-a-good-thing/

If you suspect that you or someone you love suffers from mental health disorders, contact Athena Care today.

One of our friendly associates will help you get the help you need. Take this first step to feel better and take control. 

(615) 320-1155