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SKL

Testing, Insurance - for those who did it "professionally," the how ...

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I have decided I'm going to get both of my kids "tested" for several reasons.  Giftedness is part of it (for one of them).  Did any of you get this done by a professional covered by health insurance?  If so, how did you go about it?  What did you get from the testing?  How did it help, especially if your child is in b&m school?

 

My previous HMO (which closed down last year) led me quickly to a dead end, but now I have regular health insurance (Medical Mutual) so I am hoping we can tap into some good resources.

 

Thanks in advance!

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I HIGHLY doubt you'll get any insurance company to cover this.

Where you might save some money is taking them to a university.  It might involve students working with experts to train in how to administer the tests, but they'd charge you less.

 

 

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My experience is that if there are enough symptoms of some medical DX (ADHD, ASD, etc), insurance will cover the evaluation, but not for GT and often not for learning disabilities. Schools usually still want to do their own testing, but having paperwork can push them into taking a closer look. In our experience, school testing was very brief and cursory, private testing more thorough. We have not done anything but Talent search testing past the age 6 sweet spot, though.

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ADHD and autism evaluation was partially covered by PPO insurance and we paid the remainder with HSA. The WISC-IV test my kids took was paid from HSA. So we didn't pay anything out of pocket as my husband's employer gives a decent HSA amount yearly. We split the testing so ADHD and autism was done at end of year when we are already maxed out and then the WISC the next year so we can max out the annual deductible or out of pocket (forgot actual terms, did this years ago).

 

My kids were still in public school when we did the testing. It just answers the question to teachers and outside instructors of whether my younger is ADHD or autistic as he has traits of both. It became a question of is he distracted because he is bored and/or ADHD. Is his social skills lacking because he is autistic and/or is he is a sheltered younger kid who gets his older brother to do everything for him.

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Insurance wouldn't cover testing for us. Our schools do not have gifted and honors is placement by achievement and demographics. I used PSAT for JHU-CTY ( can't do that now)and for high school. With a 95% score in English, the high school very reluctantly allowed my dc a seat in AP Lit. disparate impact rules here. In the end, it doesn't matter..public school is teaching so little that most college prep are putting significant time into sports and music unless they can afford DE or online courses.

Edited by Heigh Ho

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Insurance did not cover the testing for us. They also did not cover testing for suspected learning difficulties as well. But, if those are the issues, if you talk to the tester, then, you might be able to work out a better pricing. University testing is cheaper, but you have to pay someone else to interpret the results, which costs money. Our pediatrician only recommends testing for suspected autism and that was not our case. We tested twice and actually saw some numbers go up between the first testing and the second. So, that data was helpful for us to know that some asynchronies were disappearing with age. We have not used the information for any outside help or to access resources. 

The information helped us set the academic bar higher for our child.

Edited by mathnerd

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We're in the process of doing some testing. I don't know exactly what all we'll end up having tested. His is part of a neuro-psych eval. It will end up being 3-5 sessions of 2-3 hours each. Both our primary and secondary insurance cover it without pre-authorization, but he does have ASD and SPD and tested high for ADHD (though not as a formal dx since the psychologist feels that SPD often causes ADHD-like symptoms even without actual ADHD), so I don't know if they would've covered it without that ASD dx.

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Insurance wouldn't cover a neuropsych eval even when it was related to previously diagnosed medical disabilities (autism and hearing loss). They would only cover it in the event of brain injury or trauma like a stroke. They did cover an ADHD evaluation by a regular child psychologist (total waste of time since we had a long "paper trail" of ADHD symptoms).

 

Previously we had an evaluation by a developmental pediatrician covered by a different insurance company but that didn't include IQ or cognitive abilities.

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Interesting ... brain trauma from malnutrition (and also emotional trauma) could be a factor for one of my kids, so I will see if that matters ... I also wonder if they have any exceptions for adoptees, as being an international adoptee is considered a sort of disability for some purposes.  (I don't think disability is the right term, but they qualify for some stuff just by virtue of that.)

Edited by SKL

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Our insurance covered a little of it once we reached deductible. My son was assessed for ASD and ADHD though. The WISC-V ended up being invalid due to scatter. And ADHD was confirmed.

My son's charter school will retest his IQ in several years due to my son having an IEP. But that is only if we stay in the charter school. Which is unlikely.

So we may never get a more reliable test done because of it being out of pocket.

Edited by Korrale

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Interesting ... brain trauma from malnutrition (and also emotional trauma) could be a factor for one of my kids, so I will see if that matters ... I also wonder if they have any exceptions for adoptees, as being an international adoptee is considered a sort of disability for some purposes.  (I don't think disability is the right term, but they qualify for some stuff just by virtue of that.)

Some children's hospitals have programs for kids adopted from overseas. I am not sure what wording you'd need to go searching, and it could be for kids that were adopted with already known special needs vs. any adopted kids. It wouldn't hurt to ask around.

 

I think anxiety is also a diagnosis code that will get at least some testing paid for.

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Our insurance covers psycho-educational testing as long as we use an in network psychologist. Our reason for testing was due to suspected ASD (and he'd already been diagnosed with anxiety). Perhaps that mattered, but from what we could tell the insurance would have covered testing for any reason. I don't think that's the norm, though.

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It was not covered by my insurance and we had to save up to do it.  That being said our kids tested much higher than anticipated (perhaps we were in denial!) and it was extremely beneficial in our decision to homeschool part time and do B&M part time.  

 

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We were not able to get it done via insurance. We did get testing done twice though, without being charged for it. The first time, we enrolled in a multi-year study at a research hospital, culminating with 2 days of neuro-psych testing at age 6. The second time, at age 11, a doctor suggested we ask for CORE testing through our child's school, and the school included WISC testing in their evaluation.

 

editing to answer, did it help?

 

Hmm, the first time, it was useful for us, but irrelevant for our child's school. At that age, the teachers and principal were of the mind-set that we needed to get our child adjusted to the school's program, and not the other way around. 

 

The second time, in middle school, the report from the evaluation specifically recommended that teachers find ways to differentiate beyond what they usually did. Some have, some haven't, but at least there is more differentiation built into middle school. It did help us get our child out of a social-thinking workshop that a small group of students got placed in. Our kid hated it, and said "just because I am not neuro-typical doesn't mean they need to train me to conform to their expectations." We were able to argue that an academic "stretch" workshop was more in line with their own neuro-psych report.

Edited by slackermom

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