AimeeM Posted August 12, 2014 Share Posted August 12, 2014 Can somebody walk me through this? DD13 has a medical dx, given by a standard pediatrician many, many years ago, of ADD/ADHD. Out of curiosity, I called our new (awesome) insurance company to find out what our benefits would be if we pursued a full neuropsych eval for Autumn. If I'm honest, it is only PARTIALLY about the ADHD, but mostly to ascertain what, if any, underlying learning differences she has (see my other post about the public school ed psych eval that came back with confusing results, because they can't - basically - confirm or deny anything, lol). Imagine my surprise and delight when I'm told that our wonderful new insurance plan will cover a MEDICAL neuropsych eval, for the ADHD, at 80%! Our previous insurance did no such thing! Our deductible to be met for DD is only $200, so that added to our 20% will still be negligible compared to quotes by previous insurance companies. I do NOT have to have a referral either. So basically I simply call the neuropsych that I want (most are "in network" for us, so no problem there) and request an eval. Now, I *do* have to make sure that this is coded as for the ADHD (and it IS - partially - I want to know if it's as "severe" as they say, especially as DD presents with NO behavioral issues). When I do that, will they automatically evaluate for learning disabilities too? Does a "full" neuropsych eval evaluate for everything - or just what it is "coded" as? Quote Link to comment Share on other sites More sharing options...
Mom22ns Posted August 12, 2014 Share Posted August 12, 2014 What great insurance! I would talk to the neuropsych when you call to schedule as far as what your insurance said they will cover and what the neuropsych can do within that code. The Neuropsych may want to call and talk to the insurance company directly as well to confirm coverage for all services/testing he/she feels would be appropriate. Sounds like a great opportunity to get some answers. I'd get on the phone right away and see who will see you and what the waiting times are! Quote Link to comment Share on other sites More sharing options...
AimeeM Posted August 12, 2014 Author Share Posted August 12, 2014 I just talked to a psychologist who (woot woot!) actually homeschools her own children, lol. She said that it sounds like they will cover the ADHD porition - but not the learning disabilities portion. She's going to call the insurance for me, confirm what they will and will not cover, and send me an adjusted quote. Just that they will cover most of the eval would be helpful, even if we have to pay completely OOP for the learning disabilities portion. Quote Link to comment Share on other sites More sharing options...
Mandy in TN Posted August 12, 2014 Share Posted August 12, 2014 Will they pay to diagnose dyslexia? It is considered medical. Quote Link to comment Share on other sites More sharing options...
AimeeM Posted August 12, 2014 Author Share Posted August 12, 2014 Will they pay to diagnose dyslexia? It is considered medical. It isn't considered medical in SC. No, they won't pay for that - but they will pay for the medical (ADHD) portion, and I believe the IQ portion. She's going to check our mental health coverage to see if there's anything they'll cover from that end. Quote Link to comment Share on other sites More sharing options...
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