Aetna Coverage for Attention Deficit Hyperactivity Disorder Therapy Treatment (2024)

An Overview of Attention Deficit Hyperactivity Disorder (ADHD) Symptoms

Attention Deficit Hyperactivity Disorder, also known as ADHD, is a neurodevelopmental disorder that affects both children and adults. This disorder can cause a range of symptoms that can significantly impact your daily functioning and your emotional well-being. When you have a better understanding of your mental health concerns, you can then learn effective ways to cope with and manage them.

Children who have ADHD begin showing signs around age 6, and in some cases, even as young as 4 years old. For some, signs and symptoms continue through adolescence and into adulthood. Let’s begin by diving into some of the common signs and symptoms associated with ADHD:

Core Symptoms Associated with ADHD include:

• Inattention:
  • Difficulty maintaining focus on the task at hand or play activities
  • Making careless mistakes in schoolwork or other activities
  • Being easily distracted by extraneous stimuli
  • Appears to not listen when spoken to
• Hyperactivity:
  • Consistent fidgeting or tapping of hands and feet
  • Inability to remain seated in situations where it is expected
  • Running or climbing in inappropriate situations
  • Talking excessively
• Impulsivity:
  • Blurting out answers before questions are fully asked
  • Difficulty waiting for one’s turn
  • Interrupting or intruding on others’ conversations or activities

Additionally, those living with ADHD may struggle with emotion dysregulation, struggle to find and maintain motivation, and experience cognitive challenges. These experiences can include emotional outbursts, irritability, loss of motivation to complete tasks, poor concentration, and having a hard time staying organized. The effects of these symptoms can be seen in academic and work performance, within social situations, and create physical health concerns. Common co-occurring disorders among those living with ADHD include anxiety, depression, other mood disorders, and substance use disorders.

Can you Treat ADHD Without Medication?

It is possible to use non-pharmacological interventions to treat ADHD. This can include cognitive behavioral therapy (CBT), supportive counseling, and support groups for ADHD. While medications are a commonly used strategy in ADHD treatment, some individuals do not wish to use medications, and some have tried them and decided that medications were not the right path for them.

Counselors can help you learn lifestyle changes that can help you effectively manage and cope with your symptoms. This can include organizational skills training, mindfulness practices, and regular physical activity can help individuals manage psychological distress rooted in ADHD. Dietary changes and supplements may also be discussed as potential lifestyle changes.

Does Aetna Cover the Cost of ADHD Treatment?

Yes! Aetna members are typically able to access a variety of treatment options for their ADHD symptoms. This often includes comprehensive care tailored to your unique needs. Since Aetna offers customizable treatment options, there may be notable differences with the details of your plan, including providers within your healthcare network, the need for prior authorizations, and out-of-pocket expenses.

For some, ADHD treatment is needed continuously, to properly manage symptoms and maintain functioning. Aetna’s coverage for ADHD treatment often accommodates the duration of treatment needed, including medication management services. If you would like to learn more about your ADHD treatment benefits through Aetna, we encourage you tocall (866)461-4474today!

Does Aetna Provide Coverage for ADHD Therapy and Counseling?

Yes,Aetna’s mental healthcoverage typically provides coverage for ADHD therapy and counseling. Keep in mind that the2010 Affordable Care Actrequires health insurance providers to offer coverage for inpatient mental health treatment, psychotherapy, and substance abuse treatment. ADHD is classified as a mental health condition, which often falls within the scope of this legislation.

Aetna coverage for ADHD may include various mental health treatment options, including both inpatient and outpatient treatment programs, depending on your individual needs. Additionally, behavioral therapies and family counseling may fall within the scope of your Aetna coverage.

Does Aetna Cover the Cost of Psychiatrist Visits for ADHD Treatment?

Psychiatrists can play a critical role in your treatment experience for ADHD, which is why it is often included in Aetna coverage. Psychiatrists use various ADHD screening tools, which can be used to formulate an accurate diagnosis. They can also review ADHD medication options, and provide necessary prescriptions.

Coverage for psychiatrist visits typically includes initial evaluations, follow-up appointments, and medication management services. It’s important toverify, or check the scope of your coverage, including the extent of coverage, required referrals, and potential out-of-pocket costs associated with psychiatrist visits.

Does Aetna Provide Coverage for ADHD Medication?

Aetna typically provides coverage formedication-assisted treatmentwith commonly used ADHD medications. Your prescription drug coverage may include stimulants, non-stimulants, and antidepressants that may be used to treat ADHD. Your coverage may also provide coverage for individuals who require medications for additional mental health disorders, known as co-occurring disorders.

The specific medications covered and any associated costs in the form of copayments, deductibles, or premiums, may apply based on the details of your personal Aetna plan. Additionally, your plan may have specifications about the use of name-brand medications compared to generic options.

What are Commonly Prescribed Medications used for ADHD Treatment and Covered By Aetna

Aetna covers a range of medications that are commonly prescribed for ADHD treatment. These examples represent some, but not all, of the medications typically covered. Your psychiatrist or prescribing physician will review medication options as they relate to your symptoms, and continue to monitor until you have found the right medication and dosage.

Attention Deficit Hyperactivity Disorder (ADHD) Treatment Programs Covered by Aetna

You may find yourself wondering, does Aetna cover ADHD therapy if you’re experiencing symptoms. The good news is that Aetna does cover various ADHD treatment programs, including residential inpatient, partial hospitalization, intensive outpatient, and outpatient programs. These programs can provide you with comprehensive care to effectively manage various symptoms and levels of impairment due to ADHD.

Aetna’s coverage typically includes therapy, medication management, and other essential services, ensuring that you receive comprehensive care that can aid you in your mental health journey. Insurance plans with Aetna do have variations, which may affect your coverage for ADHD treatment programs. As an example, you may have limited out-of-network coverage, making in-network providers an ideal option. We encourage you to complete ouronline verification formto learn more about your coverage for ADHD treatment programs.

How Much Does ADHD Treatment Cost Without Aetna Coverage?

If you’re wondering, how much Aetna cover for ADHD treatment, we encourage you to begin learning about your policy byverifyingyour policy with our online verification form.Without insurance, the cost of mental health treatmentcan vary based on the individual services you receive and personal characteristics. Treatment for adults can range from$4,929 and $5,651.

The cost of treatment is based on the services you receive. Generally, inpatient treatment services cost more than outpatient programs, and group therapy tends to be more affordable than individual therapy. Individuals who are taking medications to help manage their ADHD symptoms will likely need to continue engaging in medication management services with their prescribing physician to ensure they’re taking the proper dosage.

How Can I Get Aetna To Cover the Cost of ADHD Treatment?

There are several steps needed to ensure smooth access to the care you need with the use of your Aetna coverage. First and foremost, familiarize yourself with the details of your insurance plan. Understanding your plan’s specifics, such as coverage limits, copay, deductibles, and whether you have an HMO or PPO plan, lays the groundwork for navigating the process effectively.

Once you grasp those details, you can then make informed decisions about selecting an in-network provider. Opting for a provider within Aetna’s network typically results in lower out-of-pocket expenses. Next, you will verify your coverage, confirming that ADHD treatment falls within the scope of your plan. Knowing these details upfront can prevent unexpected expenses and delays in receiving care.

Throughout the treatment process, your healthcare provider will submit medical claims to Aetna on your behalf. If you have specific questions about your policy or the admission process for an ADHD treatment program, we encourage you tocontactour Admission Counselors bydialing (866)461-4474today!