Getting Insurance to Cover a Stimulant and Strattera

Q:

"My son is doing well on the stimulant-Strattera combination his doctor prescribed, but the insurance company is unwilling to pay for both meds. Any advice?"

Dr. Larry Silver specializes in treating children with attention deficit disorder (ADHD).
A:

Appeal the decision (consult your insurer’s benefits handbook or its website to find out how). The doctor may be required to justify prescribing two meds, either in writing or by telephone, so give him a heads-up. Most insurance companies will respond to your appeal quickly. If your appeal is rejected, move up the chain at the company and ask about the next step. Don’t let your insurance company practice medicine. Your son's physician should be the one to decide which medications he should take.

Larry Silver, M.D., is the author of Dr. Larry Silver's Advice to Parents on AD/HD and The Misunderstood Child: Understanding and Coping with Your Child's Learning Disabilities. He is also a clinical professor of psychiatry at Georgetown Medical Center in Washington, D.C.
 
 
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