Child has ADD, temporarily uninsured

My 6-year-old son was just diagnosed with Attention Deficit Disorder (ADD).  He will be covered by my ex-husband’s health plan from his new job, but that plan does not start for another 60 days.  In the meantime, our son has no health insurance and he is supposed to start taking expensive drugs.  Will my ex’s health plan cover our son’s ADD or is it a “pre-existing condition”?  And what should I do about these prescriptions?  We cannot afford to pay for them, but I hate to see him struggle for two months.

Attentive Mom At A Loss

Dear Attentive Mom,

The good news is that your son’s ADD will be covered by the group health plan, when that starts.  As part of the Affordable Care Act (also called “health reform”), group plans have to pay for whatever illnesses a child under age 19 has – no matter if it was diagnosed before he joined the plan, and no matter if he was uninsured before joining the plan.

And there are a few things you can do to afford the prescriptions while you wait for the new plan to start.  If the drug were to treat anything other than ADD, you might have been able to get samples from your doctor.  Doctors cannot give samples of these drugs, because they are worth money on the black market.  So, you can go to the drug’s maker.  Get the name of the drug and find the drug manufacturer’s website.  On the website, search for “patient assistance”.  Nearly every manufacturer has programs to help uninsured people get the medications that the company makes.

Though you cannot get drug samples, you can ask your son’s doctor for suggestions.  There may be a local foundation that assists children with ADD or uninsured children.  Your son’s school nurse may also have some good ideas for you.

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Linda Riddell

About Linda Riddell

A published author and health policy analyst with 25 years’ experience, Linda Riddell's goal is to alleviate the widespread ailment of not knowing what your health plan can do for you.