Insurance Doesn't Cover My Daughter's ADHD Medication

Filed Under: ADHD Medical Care and Insurance, ADHD Stimulant Medications, ADHD Medication and Children

Q:

Our daughter was recently diagnosed with ADHD, and her doctor prescribed Vyvanse. Our insurance covers only Adderall or Focalin. From the doctor’s description, it doesn’t seem like these two meds would work as well for our daughter. Can insurance companies cover only certain types of medication?

Dr. Larry Silver M.D. is the author of two books about parenting ADHD/LD children.
A:

Your problem with medication coverage is not uncommon. Many insurance companies cover only generic forms of ADHD medications, since they are less expensive. Vyvanse is new and under patent, and, because of this, expensive. Vyvanse works like Adderall, but each drug is released into the body in a different way.

Ask your physician to contact your insurance provider and explain why Vyvanse is essential for your attention deficit daughter. The insurance company might approve its use, but I would not count on it. You may need to pay out-of-pocket for it, or choose another form of the medication.

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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