ADHD in kids: Coverage for treatment and diagnosis

Find out how your health plan can help with ADHD diagnosis, medications and more.

Diagnosis rates of pediatric ADHD (attention-deficit/hyperactivity disorder) are on the rise. According to a 2019 Health of America report, ADHD diagnosis rates in children have increased 31% since 2010.

Read on to learn how your health plan covers the diagnosis and treatment of ADHD.

Symptoms and diagnosisSymptoms and diagnosis

Signs of ADHD usually show up in kids before the age of seven. According to Dr. Jim Polo, Medical Director of Behavioral Health at Regence, these symptoms fall into three categories:

Inattention: Has trouble staying focused, daydreams frequently, appears not to listen when spoken to

Hyperactivity: Fidgety, moves around constantly, talks excessively

Impulsivity: Blurts things out, interrupts others, can't wait
for questions to be asked

Diagnosis of ADHD can be made by your child's pediatrician or by a mental health professional, like a psychologist or a psychiatrist.

Treatment with medication

The American Academy of Pediatrics recommends treating ADHD with a combination of medication and behavioral therapy.

For some kids with ADHD, medication alone works just fine, says Dr. Polo. However, ADHD medications can be expensive.

One way to manage costs while finding the best medication for your child is by using MedSavvy®, an online tool that helps you compare medications side-by-side for costs, effectiveness and safety. You can even connect with a MedSavvy pharmacist if you have questions about a treatment. Learn more about MedSavvy.

However, most kids need a combination of medication and therapy to address the larger behavioral and emotional issues. Pediatricians can prescribe ADHD medication, but they can't provide behavioral health therapy.

Treatment with therapyTreatment with therapy

Ask your child's pediatrician for help finding a behavioral health professional, suggests Dr. Polo. You can also use Find a Doctor to search for an in-network provider, or call Customer Service and ask for help.

Therapy often takes place with the parents, especially with younger kids. "There's a good amount of work that you do with parents—how to set limits, how to create structure, how to be patient," Dr. Polo explains. "Because an hour a week with a seven-year-old won't accomplish much."

For older kids who are able to sit down for therapy, telehealth—a virtual visit—can help them make it to sessions, even with a busy schedule. With telehealth, kids can have a session from home, the car or wherever it's easiest.

Telehealth can be quite helpful for parents who are managing a child with ADHD, says Dr. Polo. It's also a convenient and affordable option for people who live in rural areas where there might not be any behavioral health providers nearby.

Learn more about telehealth for behavioral health treatment.

ADHD resources

Learning more about ADHD can help you be proactive when it comes to your child's health. There are many resources online from groups like CHADD (Children and Adults with Attention-Deficit/Hyperactivity Disorder), and NAMI (the National Alliance on Mental Illness).

Although ADHD can't be cured, it can be successfully managed. "ADHD is something that you learn to live with," Dr. Polo says. "You create strategies for yourself to be more organized, you create strategies for yourself to be more focused. There are all kinds of things you can do to maximize your ability to reach your potential."

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