Blue Cross Blue Shield (BCBS) Attention Deficit Hyperactivity Disorder (ADHD) Treatment

What are Signs and Symptoms of Attention Deficit Hyperactivity Disorder (ADHD)?

ADHD is a mental health disorder that looks different for many individuals. While there are common symptoms experienced, there are different types of ADHD that are associated with their unique symptoms. We will get into differentiating these types momentarily. First, let’s review some of the common symptoms associated with ADHD so you can compare them to your personal experiences.

There are two categories of ADHD symptoms, inattention and hyperactivity. For adults, 5 or more symptoms need to be present from one, or both categories, for a minimum of 6 months. In most cases, symptoms can be traced back to adolescence and childhood. Additionally, symptoms need to present in more than one setting, impair functioning, and not be the result of other mental health conditions or substance abuse. Common symptoms of ADHD include: 

• Inattention Symptoms
  • Making careless mistakes at work, school, or within other activities 
  • Having difficulty maintaining attention on the task at hand 
  • May not appear to be listening to spoken directly
  • Has a hard time following directions because of losing attention, or becoming sidetracked 
  • Has a hard time organizing tasks or activities
  • Having a dislike for things that require mental effort over a long period of time, including homework or workplace tasks
  • Loses or misplaces needed objects like car keys, cell phone, wallet, etc. frequently
  • Becomes distracted easily
  • Forgetful throughout the day in typical parts of a routine

• Hyperactive Symptoms
  • Frequently fidgeting or taping hands or feet
  • Adults may find themselves feeling restless throughout the day which makes them feel like they need to move their body
  • Enjoying leisure time activities that have more stimulation, compared to quieter activities
  • May be described as “on-the-go”
  • Talking excessively
  • Often blurts out an answer before a question or interrupts others while they are speaking
  • Often has trouble waiting their turn.

Is Attention Deficit Hyperactivity Disorder (ADHD) a Genetic Condition?

As of yet, researchers have been unable to pinpoint an exact cause for ADHD. The information that we have learned from years of research is that there are likely some factors that come into play, including genetics and your environment at a young age. Examples of environmental factors being targeted in research include nutrition, brain injuries, and exposure to social environments. 

This aligns with most mental health disorders, in that they are individualistic in their nature, development, and in the treatment they require. With effective mental health treatment, you can learn to improve your focus, reducing the challenges you may experience when it comes to completing certain tasks. Since ADHD symptoms can affect various aspects of your life, there is a good chance that you will see a reduction in psychological distress when you can effectively cope with and manage your ADHD symptoms. 

About Blue Cross Blue Shield; Quick Overview

Blue Cross Blue Shield (BCBS) began as a collaboration of two insurers, providing healthcare coverage for medical services. BCBS is a federation of independent companies united under the BCBS Association, which sets it apart from its competitors. This decentralized model allows BCBS to tailor services to regional needs while providing access to collective resources. 

BCBS offers comprehensive and individualized health plan options for individuals, families, and employers to address physical and mental health needs.

BCBS Plans and Services

Examples of common plans and services available with BCBS include:

• Health Maintenance Organization (HMO) Plans: These insurance plans require that you have a primary care physician that you work with regarding your medical concerns. When appropriate, your doctor can provide you with the appropriate referrals to specialists who are in-network with BCBS. 

• Preferred Provider Organization (PPO) Plans: With PPO plans, you have more flexibility to see healthcare providers who are out of network, though in-network providers tend to be more affordable. You will not need to obtain a referral from a primary care physician to see a specialist for a health concern. 

• High Deductible Health Plans (HDHPs): HDHPs have lower premiums but higher deductibles. They’re often paired with Health Savings Accounts (HSAs) where you can save money tax-free for medical expenses.

• Exclusive Provider Organization (EPO) Plans: EPO plans offer coverage only for in-network providers, and often have lower premiums when compared to other insurance plan options. 

• Point of Service (POS) Plans: POS plans combine components of both an HMO and PPO plan. You’ll choose a primary care doctor to work with, and you’ll also have the ability to see specialists without a referral. 

• Medicare Advantage Plans: These plans bundle Medicare Parts A, B, and often D into one package, all of which provide additional benefits including vision, dental, and prescription drug coverage.

• Medicare Supplement Plans: Also known as Medigap, these plans help cover out-of-pocket costs not covered by Original Medicare, such as copayments, coinsurance, and deductibles.

• Dental and Vision Plans: Optional coverage for dental and vision care needs, which may include cleanings, exams, and glasses or contact lenses.

• Prescription Drug Plans: Coverage for prescription medications, often available as standalone plans or as part of a comprehensive medical plan.

• Behavioral Health Services: Coverage for mental health and substance abuse treatment, including therapy, counseling, and inpatient services.

• Wellness Programs: Resources and incentives to encourage healthy behaviors and preventive care, such as gym discounts, smoking cessation programs, and health screenings.

Does BCBS Cover ADHD Treatment?

In many cases, yes BCBS provides coverage options for policyholders who are living with ADHD. Treatment for ADHD can occur in various settings, including both inpatient and outpatient treatment centers, depending on your needs. While your coverage options may vary, BCBS typically offers comprehensive coverage including therapy and counseling, and the use of psychotropic medications. 

The coverage you receive will be dependent on the details of your policy and may include out-of-pocket expenses in the form of deductibles, copayments, or coinsurance. Your plan may have limitations regarding out-of-network providers and require prior authorizations before beginning treatment. If you would like assistance understanding how the details of your policy affect your coverage, we encourage you to complete our online insurance verification form and dial (866) 461-4474 to speak with an Admissions Counselor today!

Does Blue Cross Blue Shield Cover ADHD Therapy and Counseling?

BCBS often provides its members with coverage for ADHD counseling and therapy services. This may include both inpatient and outpatient programming, and often dual diagnosis care for those living with additional mental health concerns. Those who are experiencing severe impairment in functioning often benefit from a higher level of care. 

Therapy and counseling services can be beneficial in many ways. For example, group therapy can provide you with an opportunity to connect with others who have similar mental health experiences which can help build a sense of community, and normalize some of your experiences related to your mental health. Individual sessions allow you to dive into your emotional and behavioral concerns, and learn new ways to cope and manage your symptoms. Both of these treatment options can help improve your overall level of health and emotional wellness. 

Does BCBS Cover Medication for ADHD?

Medications are a common component of comprehensive care for those living with ADHD. In many cases, BCBS prescription drug coverage includes medication-assisted treatment (MAT).

ADHD medications. There are several medication options available for ADHD, which means that you may end up trying different medications before finding the one you respond best to. 

ADHD medications are prescribed by medical professionals, who will continue to monitor your symptoms and make adjustments to your medication regimen as needed. This often takes place in an ADHD counseling and therapy treatment center. You may find that your dose needs to be adjusted over time to achieve optimal support.

Types of Medications Covered By BCBS for ADHD Treatment

BCBS prescription drug coverage may include both generic and name-brand medications commonly used to treat ADHD. There are a few different types of medications that can be used for ADHD, which is dependent on the types of symptoms you’re experiencing and the level of impairment they cause in your daily life. Examples of ADHD medications that BCBS may cover include:

Attention Deficit Hyperactivity Disorder (ADHD) Programs Covered by Blue Cross Blue Shield

If you’re one of the many wondering does Blue Cross Blue Shield covers therapy services, you’re in luck! Blue Cross Blue Shield prides itself on providing comprehensive care for policyholders, which often includes an assortment of treatment options. Each treatment program is designed to support individuals with set symptoms and levels of impairment. Commonly used programs for treating ADHD include: