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Has anyone had any luck having insurance pay for a psych/ed eval?


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My son is due for his psych/ed eval since he was tested in first grade at the ps. He's reading beautifully, now, but I'm concerned about his writing which is below grade level and frustrates him immensely. I also think there are anxiety issues that should be evaluated. I suppose we can jump hoops through our district, but I was just told by our referral gal at the peds office that (very rarely) our insurance (United) will cover it. Supposedly the initial eval will be covered, but not necessarily the actual testing. So there's a small glimmer of hope that we won't have to go through the district, which I don't fully trust and would prefer not to deal with.

 

Has anyone had any luck getting your private insurance to cover it?

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Does your insurance have mental health benefits? We're currently going through the process of trying to get neuropsych testing approved through our insurance.

 

It does, but with a limit which I can't remember.

 

Ooohhh, ASU- I hadn't even thought of that!

 

Our initial consult was going to be through the Children's Hospital, as well. They are sending me forms, but I have no idea how long the wait is. Five months is a long time to wait. But, for a copay, I suppose well worth it.

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Although I have never had to have a referal for anything to date, I started this evaulation issue for our son with our primary care doctor. We then saw the neuropsychological doctor at the children's facility who then sent us on to the audiologist and speech therapist. No problems with insurance once our deductable was met. We also went the route of using a reputable university for our big psychological evaluation. The head of the department oversaw the testing so to speak, but one of the master students did the actual asking of the questions. This was a great experience and very afordable. Our insurance wouldn't cover any of this so it was much more affordable than using someone in private practice.

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Our insurance covered Neuropsychological testing for all three boys. Our copay only ended up being $44 per child. We went through our local children's hospital's

 

All of the testing at the hospital were covered. BUT they showed DD as borderline in everything, and therefore couldn't/wouldn't recommend her for services. I knew there was more, so we ended up goign out of network to a private facility and we paid $1200 (about) for testing and got PDD-NOS diagnosis; Asperger's if there was a social component. She's aspie. :glare: Sitting one on one doing puzzles (testing) is a lot different than social settings.

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Wow! I'm impressed so many people have gotten it covered. Of course, nobody is posting who DIDN'T get it covered. LOL.

 

I did contact our University just to see what they offer and how much.

 

Thank you so much for your responses.

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Wow, I guess we are fortunate.. Our insurance (military-Tricare) paid 100% for all psychological and neuropsychological evaluations on all four of my kids.. They also pay 100% for just about all therapies and any biomedical testing or treatment we have needed.

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Our insurance specifically excludes education testing so I'd definitely call insurance to check benefits ahead of time. Ours also excludes all therapy for developmental disabilities and vision therapy. I'm thinking of going through the school district to get my 7 yo son tested for dyslexia so I do not have to pay out of pocket. I'm not sure I want the headache of dealing with the school district though. We did go through them for testing for our 3 yo and they weren't that well done so we are pursuing private evaluations anyway.

 

Our policy is self funded and I've noticed it tends to cover a lot less than a policy that is fully funded. Fully funded policies are subject to state mandates while self funded policies are not. None of my son's autism therapies are covered despite living in a state with an autism mandate because our policy is self funded.

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