Help needed from parents of ADD children

[freakygirl]

I don't think that's legal. Him, not you. Unless he's terminated all of his rights, that is.

He works in the insurance business.. but I guess he doesn't have insurance available through his employer.

My income (they can't count Mr Freakys income because we aren't married) is low enough that I can get Basic Health.

 

[miles]

Actually, they farm that part out to gatekeepers that make the decision. For example, United Healthcare uses United Behavioral Health, Aetna uses Magellan, Cigna uses Innovative Resource Group, etc. Those are the people paid to say "no".

The rest of your post is right-on, though. HR department!!

I don't know where you get your info, but self insured companies make the final determination as to what is and isn't covered.

 

[SpiceCake]

We always had good luck with Adderall. I think with documentation on your daughter's actions on each of the medications, you may be able to make a case to get the insurance to pay for the Adderall. You will need the assistance of her instructors, doctor and your family. Remember, what is best for your child should come first. Be her champion and fight for her well-being. I'm in your corner, FG! Good luck!

 

[freakygirl]

I talked to Kimber. She brought up the medication problem to me. She wanted to know if she could go back to the other pills. She didn't like the new ones. They didn't help any. And she liked it when the medications were helping.

I've been reading the book that the insurance company sent me..

Looks like I either stick with Concerta.. or pay for the Adderall myself. If thats the case.. I'll pay for the Adderall.

Thank you everyone.

 

[Guest]

I don't know where you get your info, but self insured companies make the final determination as to what is and isn't covered.

I deal with the gatekeepers every day. Self funded ones farm them out, too. I do this for a living. I think we're confusing what is an exclusion and what is approved or denied. You're right as far as "drug X isn't covered on the policy" but not for "we don't WANT to cover that". I'm kind of splitting hairs here, I admit that. Gatekeepers do repricing and say "no" (spend the insurance company's money) but employers determine exclusions of coverage, yes.

 

[freakygirl]

Oh this is seriously fucked up.

Ok.. Kimbers primary insurance is Premera Blue Cross.. secondary is Medicaid. Premera pays first.. then what they don't cover Medicaid pays (so I don't have any out of pocket expenses except for the $30 a month).

In her medical information booklet.. it says they don't pay for certain drugs. Adderall being one of them. They don't pay for psychiatric help for ADD children (but they do for adults).

Mr Freaky also has Premera Blue Cross insurance through his employer (Which just happens to be the state of Washington). In his medical information booklet (which looks identical to the one Kimber has) it says they pay for Adderall.. and psychiatric help for children with ADD.

I wonder if Mr Freaky and I got married.. if Kimber would be covered under his insurance?

Basic Health of Washington State sucks.

 

[Guest]

Why don't you convince him to put her on his policy?

 

[Fly_On_Wall]

talk to parents of ADD kids

why not talk to an ADD person themselfs.

me and my brother both have it.

dosn't affect us as much as it use to but as kids could not concentrate on a thing.

my parents took different approaches to each of us cause we reacted differently.

my brother took the meds.
reactions were.
Paid more attention in school remebered everything the teachers said (still couldn't apply it) so my parent helped him out.
he alos lost all his energy he had so much of before. so his sports took the toll for this and he wasn't as good at them anymore.
he was a better kid for the most part however come a years time the drugs didn't work anymore his system adapted to them
Mabey your daughter is adapting to the drugs as well. (just a sugestion)

as for me I attacked my parents when they tryed to give me the medication Physicaly attacked them with anything I could find. I spit it in there faces smashed the bottles and kept trowing it downt he drain. Parents gave up on me and didn't give me the medication like they did my brother.

but I now Knew I had a problem and hated the extra attention my brother got from school work problems so I decided to do something about it.
I was never able to controle my wondering attention. and still have trouble reading but I used my extra energy to learn in different ways (we have ADHD H = Hyperactive). TV. Vid games and board games... yes that sounds stupid but it's how I learned
If I had taken my pills would have lost that hyperactive energy like my brtoher did and I don't think i would have chaneled it into learning

dont' know if that helped you but my point was to show that sometimes the pills do help sometimes they make things worse and sometimes they do nothing at all.

so just watch your daugthers progression if she goes back to the old pills if nothing happens try takeing her off them for awhile

find ways of getting her attention. find what she likes (even people with ADD have something they won't budge for and focous all there attention on) when you find it use that for her own good.

Whatever happens I hope her the best.

 

[freakygirl]

Why don't you convince him to put her on his policy?

Can I? He is more than willing to do that. But I thought we had to be married or she atleast had to be his child. Whether it was by adoption or biological.

I guess I'll see what I can find in the book..

 

[Guest]

Can I? He is more than willing to do that. But I thought we had to be married or she atleast had to be his child. Whether it was by adoption or biological.

I guess I'll see what I can find in the book..

Every state is different.

And your reference to him as "Mr. Freaky" has me confused. Boyfriend Freaky only? Does Bio Dad have rights to her? If so, what is his insurance?

 

[freakygirl]

Fly

I appreciate your post. Really I do. But it isn't a fact of her body adjusting to the medications... she is newly diagnosed. Adderall was the first medication she was put on.. and it worked great. Insurance changed... so the coverage wasn't the same..so the meds had to be changed.


I have talked to parents of ADD. My boyfriends ex wife and I spend a lot of time on the phone.. three of their children are ADHD. Kimber is only ADD. and from the way I understand it.. it's a "mild" case. Meaning that in time.. they feel that she will be able to control it without medication. But until she learns how to do that.. she needs the medications. Or her learning will suffer. Not something she or I want. She will start to learn how to control it next summer. I've checked into that.. and it is paid for already. I'm using the rest of a little bit of money I had saved to pay for that.

Thanks for your input, Fly. And good luck to you

 

[freakygirl]

Every state is different.

And your reference to him as "Mr. Freaky" has me confused. Boyfriend Freaky only? Does Bio Dad have rights to her? If so, what is his insurance?

ok.. Mr Freaky is my boyfriend. Not Kimbers father. Bio father has rights.. and visitation. He won't give up his rights.. and honestly, I don't really want that. She knows him and loves him. He loves her.

From what I've been told.. he doesn't have insurance coverage.

I have 3 Adderall capsules left.. would I be ok to give her one tomorrow morning instead of the Concerta. She knows that the Concerta isn't working.. has a reading and spelling test and is worried about not doing well. She also has a cheerleading compition on Saturday that is important to her.

 

[freakygirl]

UGH!

Ok.. Mr Freakys insurance will cover his spouse (for a small montly payment of $129) or same sex domestic partner (for no additional cost) , biological children, step children and children of his same sex domestic partner...but not me.. or my daughter.

*shrugs* I don't get it.

 

[freakygirl]

*bumping back up to the front page cuz I can*

 

[freakygirl]

*bump again*

 

[Barely__There]

I talked to Kimber. She brought up the medication problem to me. She wanted to know if she could go back to the other pills. She didn't like the new ones. They didn't help any. And she liked it when the medications were helping.

I've been reading the book that the insurance company sent me..

Looks like I either stick with Concerta.. or pay for the Adderall myself. If thats the case.. I'll pay for the Adderall.

Thank you everyone.

Freaky, check to see if your insurance will pay the Concerta price, and let you make up the difference for the Adderall. If they are being asses because of bottom line, they might go for that. I know that my insurance company will pay only the base generic rate for drugs, and I make up the difference, unless it is a physician specified brandname.

 

[Don K Dyck]

You are very welcome. PM me anytime if you need to vent. And what kind of an idiot thinks that ADD somehow affects intelligence? Some latest studies suggest that giftedness and ADD go hand in hand!

The insurance company/whomever is not giving you adequate medication for the treatment of your child's condition. Bottom line. Any competent MD or psych would have to back that up.

Kisses! Hang in there!

There is an earlier ADD thread by sweetsubsarahh which she may be able to resurrect . . . we have had good results with regular vigourous exercise . . . and a supportive family environment . . . and no chemicals . . . but this is not the only possible "cure"/"management tool".

 

[Guest]

There is an earlier ADD thread by sweetsubsarahh which she may be able to resurrect . . . we have had good results with regular vigourous exercise . . . and a supportive family environment . . . and no chemicals . . . but this is not the only possible "cure"/"management tool".

There have been several threads on this issue. The last was started by busybody, actually, and contained a great deal of misinformation! (but here's the link - others to follow)

http://www.literotica.com/forum/showthread.php?s=&threadid=133852&perpage=25&pagenumber=1

 

[Guest]

Another thread (this one started by freaky) more of busybody being a nuisance, but thank you miles for the Lit Duct Tape idea!!

http://www.literotica.com/forum/showthread.php?s=&threadid=125403&perpage=25&pagenumber=1

 

[Guest]

Here's the first thread. Truly a hot topic; you'll rarely find someone on the fence about their opinion.

My best advice to anyone is to make sure your child sees an adequate physician or psychiatrist (and as an ongoing thing - every other month or so). They'll be able to best monitor your child's progress. If you wish, ask others for their opinion, but you know your own child best - follow your beliefs!

http://www.literotica.com/forum/showthread.php?s=&threadid=123788&perpage=25&pagenumber=1

 

[Guest]

Yes, you can give the extra Adderall tabs.

 

[Guest]

Yes, you can give the extra Adderall tabs.

Hmmm - I would agree it probably wouldn't hurt, but as I am not a doctor (and neither are you?) I can't believe you're offering such a definitive confirmation.

 

[freakygirl]

Ok.. bright and early this morning I called the dr at home to ask about giving her the Adderall that I had.. he said yes it wasn't a problem.

Then I called him back later at his office (he needed to check her file to be sure what was going on.. I guess he doesn't remember every little thing about every one of his patients. Damn him ) Anyway.. Starting on Sunday she will be on 36mg of Concerta. He says what we are doing is building a case to take to the insurance company. He's dealt with this before (insurance not paying) and he says.. they require atleast two trials of a different medication and/or dosage before they finally say "ok, we will pay for the original medication". Stupid idiots! I don't understand it.

I asked him if they denied it even after all of this, could I still buy it for her and bipass the insurance company. He says ofcourse... That's what I will do if I have to.


Barely__There- I did ask that.. they won't budge for some reason.

Don K Dyck-I know this can be done without medication. Hopefully in time that will be the case. But for now.. I'm doing what I have to. But thank you for your input

sweetsubsarahh-Thank you for the links.

 

[Guest]

Hmmm - I would agree it probably wouldn't hurt, but as I am not a doctor (and neither are you?) I can't believe you're offering such a definitive confirmation.

Believe it.

 

[freakygirl]

Believe it.

I trust Storm..Even if I hadn't asked the dr first.. I would have gone with what Storm said.