Hello All,
I have recently been diagnosed with ADHD. I am 31 yrs old and have been on adderall xr for about 40days and can tell a bunch of difference.
My question for you is about your perscription coverage.

My insurance wont cover perscriptions for adult adhd does is anyone else having this problem?

If so what have you done about this?

Thanks
Dan Bennett

Hmmm....that's interesting Dan...I have been on several insurance plans in my day...and often they have limitations as to what drugs they will cover...but never have I heard of limitations according to diagnosis....they have always found some substitutes or similarities to drugs I was prescribed....Like my synthroid....one insurance place didn't want to pay for it...because they knew another thyroid med was cheaper..so they changed to that cheaper one...no problem...

That's great that you are doing well with Adderall by the way...perhaps you would respond just as well to something else they would cover? I mean they won't cover ALL ADD meds? In any event, I would check out the list of drugs they they will and won't cover....why not get a copy of that list and then re-visit your doctor and see what other options there might be for you?

It sounds like you need to get your doctor on the phone with the insurance company's medical director. Does your insurance policy specifically exclude ADHD as a condition to be covered? What was the reason they denied your benefits?

Hello,
I have been arguing with my insurance company for two weeks...they say they will not cover adult adhd for any reason. they also told me that was the norm for most insurance companies....There were 3 meds they suggested that they say would cover adhd and other problems. Catapres, Tofranil, and Norpramin...My doctor says nope those will not help my situation......At this point im clueless.....

My ins. co. has a clause that specifically "includes" ADHD as a "biologically based mental Illness". Sounds like they haven't updated the coverage for this type of disorder in a long time. If other disorders of the same kind are covered maybe you can argue it from that point.

Try writing a letter to your state insurance commissioner. Make sure you send a copy of it to your insurance company. It just doesn't sound right to me that they won't pay. Is it a really small insurance company?

I know I have brought this up in other threads too. Stimulant medications have not been approved by the FDA to treat adult AD/HD. They have only been approved to treat children with AD/HD. Straterra is only medication which has been approved by the FDA to treat adult AD/HD. Drs are still allowed to prescribe stimulants to adults with AD/HD. This may have something to do with why some insurance companies can refuse to cover stimulant medications for adults.

I also suggest writing to the makers of ADDerall.

You're right Tara. I didn't even think about that when I gave my response. I would think that he would have an argument, though, if he wanted to try Strattera and his insurance company refused. What if he tried having his doctor write a letter to the insurance company? I know that insurance companies can be persuaded on an individual basis, even after an initial refusal. It's like my insurance company refusing to pay for more than 9 Imitrex in a month, even though the dosing is 1-2 pills every two hours. I guess I'm only allowed to have a certain number of migraines per month. :mad: Sure, just tell my body that! I called my insurance company and they told me to have my doctor call if I need more than that. I haven't tried it yet, but I will if I need to. Insurance companies have way too much control over doctors and their patients!