I suspect the individual encountered is uniformed or charged with screening with any excuse to limit their obligations.

Adderall is a branded product and insurance companies are continually making restrictions and obstructions to move participants to less expensive generics. In our state providers have the option of providing "equivalent" generic unless the prescribing physician specifically documents the requirement of the branded product. Our plans also has significantly greater copays for branded products. Your specific plan may have restrictions, but I doubt that it precludes servicing your needs.

While dated perceptions persist, the medical establishment acknowledges that ADHD is with us for life. Driven to Distraction (1994?) is written by ADD for ADD and provides a wealth of information riddled with resources specifically for adults. The Americans with Disabilities Act includes ADHD as a disability per the article http://www.additudemag.com/adhd-web/article/674.html. Other sources are less confident.

If I were you (Can I use IIWY here like IMHO, BTW, OMG? Or do we have another colloquial?), I'd ask the same of a different representative and task them to show you the specific language within your coverage. If the plan documentation specifically prohibits providing for you needs, bring that to your employer's attention, seek guidance from governing authorities within your state and/or consult with the manufacturer of your desired product. If that doesn't generate success, I'd seek legal council.

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Hi,

I realize that this is not the exact problem you are having in getting your prescription for Adderall covered by your insurance but I thought this may be an alternative to getting it filled under their guidelines.

In the last year a generic version of Adderall has become available. It costs much less than the Brand name Adderall. Many stores like Walmart, Target & most drug store chains, in competing for your business, offer cheaper prices for generics for something like a 90 day supply of a generic for $10-12. I'm not sure of the exact price for that special. But maybe your insurance company would pay for it since it's cheaper than the brand name version of Adderall.

I have found a great discrepancy between what one store charges for a drug than what another store charges. So it pays to shop around. Also some stores will let you buy a generic for cash & not put it through your insurance. Most times I have found that it actually costs less that way than paying the copay on your insurance plan.

Good Luck.

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