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Ask the ADD Medical Expert:
Robert Tudisco
Covering Medication
Q:
"My son and I both have ADD. He will need medication for the rest of his life. My plan will no longer cover him after he graduates from high school this spring, and he’s not starting college until the following year. Can he get disability insurance from the government?"
A:
Each state has different policies about insurance coverage and mental health. Many carriers don’t cover medication for conditions such as attention deficit/hyperactivity disorder (ADD/ADHD), because medication does not cure the condition but manages its symptoms.
I would recommend contacting your state’s Department of Insurance to find out how its insurance laws impact the needs of you and your son. You may also look into whether or not your child qualifies for coverage through the university he will be attending, and check whether the law in the state where your son will be going to college includes parity legislation—that is, mental health conditions are covered, just as physical health conditions. If he qualifies, that may resolve the issue.
Many organizations, such as CHADD, NAMI (National Alliance on Mental Illness), and AACAP (American Academy of Child and Adolescent Psychiatry), have been seeking fair treatment for individuals with mental illnesses. A bill passed on March 5 in the House of Representatives (H.R. 1424), and its counterpart in the Senate (S. 558), which passed September 18, require equal coverage for health and mental health/substance abuse treatment. The House bill would cover both in-network and out-of-network services, while preserving state parity laws on state-regulated plans.
Robert Tudisco is a lawyer who specializes in ADHD. He lives in White Plains, New York.
 7 Comments:
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Posted by
LadyJ
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Mar 25 2008 @ 11:03 AM
mood stabilizers
Forget the ADD medication that is usually manageable because the generic is so prevalent. My daughter has Bi-polar and our insurance just changed to a 5 thousand dollar deductible. She is on three mood stabilizers and the one that is working the best for her is $400 + a month! Also the need for timed release is very important and when we changed to generic, the second best one has got to be taken 3 times a day and the body medicinal levels are not consistent which makes it difficult for her to manage her disorder. She was doing so well on the name brand stuff. And we were okay with paying a $ 50 co pay, but this is ridiculous!!
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Posted by
LadyJ
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Mar 25 2008 @ 11:02 AM
mood stabilizers
Forget the ADD medication that is usually manageable because the generic is so prevalent. My daughter has Bi-polar and our insurance just changed to a 5 thousand dollar deductible. She is on three mood stabilizers and the one that is working the best for her is $400 + a month! Also the need for timed release is very important and when we changed to generic, the second best one has got to be taken 3 times a day and the body medicinal levels are not consistent which makes it difficult for her to manage her disorder. She was doing so well on the name brand stuff. And we were okay with paying a $ 50 co pay, but this is ridiculous!!
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Posted by
sundancer
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Mar 6 2008 @ 3:23 PM
Shire Program
I was on the Shire program for a year, and have just sent in another application to re-up for another year. As Leeper said, it only costs $5 per prescription, and without the help it would have cost me $135 per prescription. The student health center on campus had the paperwork on hand for me to fill out, and they even sent it in for me. Hope this helps.
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Posted by
mary
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Mar 5 2008 @ 8:05 PM
I have trouble sleeping at night.
I use to be on Ritalin. When I experienced bad side effects my doctor switched me to Dexedrine. That didn't work either so finally he switched me to Straterra. I know that Dexedrine and Ritalin are stimmulants but Straterra isn't. I read the article about taking Ritalin and Dexedrine at night to sleep better. I have trouble getting to sleep and staying asleep. Would it be better for me to take Straterra at night? Would it help me sleep better? Is there any non-medical ways I can help myself to sleep better?
I am also going on a trip that has significant time change involved. The country I am going to is 13 hours ahead of my time here. How can I adapt my sleep pattern for the trip without medication?
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Posted by
Tracy van Overbeek
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Mar 5 2008 @ 5:54 PM
Ohio Pharmacy Names
Robert,
Do you have a list of the Ohio Pharmacies that carry generic ADD drugs for $5?
My son and daughter both take adderall, that would be a big savings for our family.
Thanks,
Tracy
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Posted by
Leeper
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Mar 5 2008 @ 3:12 PM
Shire Program for Adderall Users
If he uses Adderall, Shire Pharmaceuticals has a program for those who cannot otherwise afford the medication. A monthly $5 co-payment is all that the recipient pays. Go to the Shire-sponsored Adderall website and download the application form.
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Posted by
Robert Besaw
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Feb 6 2008 @ 1:18 AM
Insurance Coverage
A few ideas:
If your son is enrolled in University your insurance may have a clause about covering him until the age of 23.
If it still won't you may also find out if the generic is available. In Ohio there are several pharmacies that offer common generics for only 5.00 including the ADD meds.
Another alternative is talking to your doctor for samples.
Last but not least is to contact the pharmaceutical company directly as they may provide you with medications until his new insurance kicks in.
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