Why would my personal insurance deny a claim for ADHD testing for my 6 yr old son?

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TPParenting asks:

The insurance company is stating a law that require the school system to pay for the testing although, the school is not requesting it, we the parents are.

In Topics: Physical Health, Learning disabilities, ADHD & attention issues

> 60 days ago

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Expert

Wayne Yankus

Apr 14, 2010

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What the Expert Says:

The school is not in the business of diagnosing disease. Their job is to implement the necessary educational support such as a 504 designation or Individual Education Plan which is what most children with ADD have in their schools.

The school psychologist or psychiatrist can do testing at your request but there is no obligation for your insurance company to pay for it that I am aware of.

Speak to your pediatrician. If it was medically required for developmental evaluation, insurance may cover it. This varies by state and is much like speech therapy which insurance companies are loath to pay for.

Wayne Yankus, MD, FAAP
expert panelist: pediatrics

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