Aetna Coverage for Attention Deficit Hyperactivity Disorder (ADHD) Therapy and Treatment

Attention Deficit Hyperactivity Disorder (ADHD) is an example of a mental health condition that becomes easier to manage with proper treatment. Insurance coverage can be used to reduce the costs of ADHD treatment, helping you improve your emotional well-being. A Mission For Michael (AMFM) is a renowned residential treatment provider for mental health disorders in California, Washington, and Virginia.

AMFM Mental Health Treatment Centers provide comprehensive coverage for an assortment of mental health disorders, including ADHD and dual-diagnosis conditions. Your treatment will begin with a thorough mental health assessment and an ADHD screening to understand your treatment needs better. Continue reading to learn about commonly used treatment approaches for ADHD, as well as how Aetna health coverage options can help you access holistic approaches to ADHD.

Psychiatrist writing notes while having therapy session with a patient.

Overview of Attention Deficit Hyperactivity Disorder (ADHD)

Attention Deficit Hyperactivity Disorder, commonly known as ADHD, can cause difficulties including inattention, hyperactivity, and impulsivity. These symptoms generally begin during childhood and can continue to cause functional impairment in adolescents and into adulthood. Adults living with ADHD commonly experience challenges in their social, professional, and personal lives.

Some of the common symptoms associated with ADHD include:

  • Inattention: This can disrupt your focus on tasks and contribute to poor concentration. You may feel distracted often. In some settings, this can be perceived as uninterested or unmotivated for required tasks. You may make careless mistakes in your work or struggle to follow directions.
  • Hyperactivity: You may struggle to sit still and fidget often. This can contribute to getting up and moving in situations where it’s expected to stay seated. Others may describe you as constantly “on the go”. Hyperactivity can also cause talkativeness.
  • Impulsivity: Impulsivity symptoms tend to cause distress in personal and professional relationships. You may cut others off when speaking and struggle to wait your turn. This is often unintentional. However, others may perceive it as rude or offsetting. Maybe you find yourself acting without thinking about the potential consequences or struggling with delayed gratification.

 

Other common challenges among those living with ADHD include emotion dysregulation, poor time management skills, procrastination, memory difficulties, and sleep disturbances. Contact AMFM today for a confidential and free mental health assessment and to better understand your mental health insurance coverage.

What is Aetna Health Insurance?

Aetna Insurance is one of the commonly used health insurance providers that offers various coverage options for policyholders. Aetna’s healthcare network commonly includes medical health providers, behavioral health treatment, and preventative care services. This can include individual, family, and employer-sponsored plans.

Examples of available plan options with Aetna include PPO (Preferred Provider Organization) and HMO (Health Maintenance Organization). Your coverage can include physician visits, hospital care, and prescription drug coverage.

Aetna was formed in the 1800s and is known as the Aetna Life Insurance Company. Since then, they have continued to evolve to meet the needs of Americans. In 2018, Aetna became a part of the CVS Health company, which has proudly been a member since. Aetna is known for providing proactive and convenient care, which contributes to its high number of members.

Find out about our free assessments and admissions process

We accept most major insurance providers and can check your coverage levels for you.

If we are not an appropriate provider for care, we will assist in finding a care provider that can help. 

Info and Statistics on ADHD in the United States

According to the Centers for Disease Control and Prevention (CDC), 15.5 million adults in the U.S. live with an ADHD diagnosis, half receiving their diagnosis in adulthood. While the average age of onset for ADHD is six, some are diagnosed as early as four. This shows that the initial presence of ADHD is individualized, and can have significant differences.

The prevalence of ADHD among adults has risen from 6.1% in 2022 to 10.2% in 2024. This reflects a growing awareness and increased diagnosis rates in adults. The highest rates of ADHD are seen among adults aged 25 to 29, with prevalence gradually decreasing as age increases. Many seek treatment to address challenges including focus, impulsivity, and interpersonal difficulties. Common treatments include medication management, counseling, lifestyle adjustments, and improving support systems. As awareness grows, more adults are accessing resources to enhance their quality of life and manage their symptoms effectively.

Can ADHD Be Treated Without Medication?

Yes, it is possible to address the psychological distress from ADHD without taking ADHD medications. Your treatment can include the use of behavioral therapy, Cognitive Behavioral Therapy (CBT), lifestyle changes, and supportive counseling. These approaches can help you make adjustments that make your symptoms more manageable and improve your overall functioning.

Treatment can introduce you to a range of coping strategies for ADHD, including time management, organization practices, and emotion regulation skills. Lifestyle changes that may be recommended for you include establishing a set routine, regular exercise, improving sleep hygiene, and breaking large tasks into smaller pieces.

How Can I Get Aetna Health Insurance To Cover the Cost of ADHD Treatment Near Me?

Utilizing the maximum benefits from your policy will significantly impact the cost of ADHD treatment with Aetna insurance. We recommend starting by verifying your insurance. This can help you understand the requirements of your policy and what your out-of-pocket expenses would be.

Verifying your coverage can also let you know if you’re required to obtain prior authorization to initiate the medical claims process. Be mindful of requirements regarding choosing in-network providers. Aetna member services can help you locate in-network providers in your area. Contact AMFM today to learn how much ADHD treatment costs with Aetna insurance, and the scope of your coverage.

Check Your Insurance Coverage For Mental Health Treatment

Insurance can be complicated but we are here to help. AMFM has over a decade of experience in the mental health field and is in-network with many large insurance providers. By using our form below, we can quickly determine if you are in-network at one of our facilities. Your insurance provider will not be notified or contacted by completing this form and the process is 100% confidential.

By submitting this form you agree to the terms of use and privacy policy and give my express written consent for AMFM Healthcare to contact me at the number provided above, even if this number is a wireless number or if I am presently listed on a Do Not Call list.

I understand that I may be contacted by telephone, email, text message or mail regarding my disability benefit case options and that I may be called using automatic dialing equipment. Message and data rates may apply. My consent does not require purchase. Message frequency varies. Text HELP for help. Reply STOP to unsubscribe.

Disclaimer

Does Aetna Insurance Cover the Cost of ADHD Therapy and Treatment Near Me?

Aetna policyholders can typically receive coverage for some, if not most, of the costs associated with ADHD therapy and treatment. Your coverage rates will be specific to your policy and current symptoms. Your plan may require prior authorization for the medical claims process, and require out-of-pocket expenses.

Individuals whose plan includes Health Savings Accounts (HSAs) can use these funds to cover out-of-pocket expenses like copayments and deductibles.

Does Aetna Provide Coverage for Attention Deficit Hyperactivity Disorder Therapy and Counseling Near Me?

Aetna policyholders can typically receive coverage for ADHD therapy and treatment. Because of their personalized plan options, it is not uncommon to have variations in coverage rates, prescription drug coverage, and preventative care benefits. Your plan may have out-of-pocket expenses like copayments, deductibles, coinsurance, and premiums for behavioral health services.

Aetna’s ADHD coverage commonly includes counseling services, peer support for ADHD, holistic approaches to ADHD treatment, and medication management services. Your plan may have requirements for working with in-network providers, or limitations and exclusions regarding out-of-network coverage. Complete the AMFM insurance verification form for personalized support regarding your ADHD health coverage options today. Our admission counselors can help you understand if Aetna covers ADHD treatment near you.

Does Aetna Insurance Cover the Cost of Psychiatrist Visits for Attention Deficit Hyperactivity Disorder Treatment?

Aetna Insurance typically covers psychiatrist visits for ADHD treatment. Covered services can include ADHD screening, diagnosis, therapy, and medication management. The details of your coverage are dependent on your insurance plan. You may have coverage for both in-network and out-of-network providers, though out-of-network providers may have higher costs.  

Your policy may require prior authorization before accessing certain psychiatric services, like comprehensive evaluation. Contact AMFM today to learn more about the requirements of your health coverage options.

Does Aetna Insurance Provide Coverage for ADHD Medications?

Aetna’s prescription drug coverage usually provides coverage for ADHD medications. This can include stimulant and non-stimulant medications. Your plan may have limitations or restrictions on name-brand medications, and require prior authorization for some medications. Prescription drug coverage commonly has out-of-pocket expenses like copayments and deductibles.

Your ADHD medication coverage is dependent on the details of your policy. You may be required to obtain prior authorization for some commonly prescribed medications.

Therapy and Treatment Programs That Take Aetna Insurance Policies for ADHD Near Me

A Mission For Michael (AMFM) Mental Health Treatment Center can provide comprehensive care for moderate to severe ADHD cases. Our programs include the use of evidence-based practices, holistic approaches to ADHD treatment, and wellness programs. Dial (866)478-4383 to learn about ADHD therapy and Aetna insurance coverage near you.

California

ADHD Programs in California

California AMFM Mental Health Treatment Centers can be located in Orange County and San Diego. Here, we provide customized treatment experiences including approaches like cognitive behavioral therapy, yoga therapy, psychoeducation, dialectical behavior therapy, and somatic therapy. Contact us today to learn about specific ADHD interventions and treatment options.

Virginia

ADHD Programs in Virginia

With multiple locations in Virginia, AMFM can provide you with a customized treatment experience in a high-end treatment facility. Available services include individual therapy, family therapy, yoga, equine therapy, yoga therapy, life skill development, and pet therapy. Contact us today to inquire about ADHD treatment services.

Washington

ADHD Programs in Washington

With one treatment facility in Seattle, Washington, AMFM provides residential care for those experiencing severe mental health concerns, including ADHD and co-existing conditions. Our comprehensive mental health assessment will identify symptoms and challenges that should be incorporated into your treatment. Reach out today to learn more.

General Inquiry Form

Complete the form below to receive a prompt call back from a member of our experienced and compassionate admissions staff. All communication is 100% confidential.

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By submitting this form you agree to the terms of use and privacy policy and give my express written consent for AMFM Healthcare to contact me at the number provided above, even if this number is a wireless number or if I am presently listed on a Do Not Call list. I understand that I may be contacted by telephone, email, text message or mail regarding my disability benefit case options and that I may be called using automatic dialing equipment. Message and data rates may apply. My consent does not require purchase. Message frequency varies. Text HELP for help. Reply STOP to unsubscribe.

Disclaimer

What are Commonly Prescribed Medications For ADHD Treatment and Are Covered By Aetna

ADHD medications belong to various classes of medications. These medications have notable differences in how they affect the body, and which symptoms they can help manage. While stimulant medications are commonly used for ADHD, non-stimulants and antidepressants can be used in some cases. Continue reading to learn more.

Stimulants:

Stimulant medications are often the first line of treatment for ADHD medications. These medications increase the levels of naturally occurring chemicals in your brain. More specifically, the neurotransmitters dopamine and norepinephrine. Different classes of medications are stimulants including methylphenidate-based medications, amphetamines, Dexmethylphenidate, and lisdexamfetamine-based medications.

  • Methylphenidate-based medications
    • Ritalin: Available in an immediate release and can provide short-term relief from symptoms. Your prescription may include several doses per day.
    • Concerta: This is an extended-release medication, which means that it offers long-lasting benefits. This option is convenient for those who need assistance in managing their medication.
    • Daytrana: This is a patch medication that offers gradual and consistent symptom control.
  • Amphetamine-based medications
    • Adderall: Adderall is composed of mixed amphetamine salts. This medication can be prescribed in immediate and extended-release doses.
    • Vyvanse: Vyvanse is a long-acting amphetamine, which can reduce the likelihood of misuse and abuse.
    • Dexedrine: Also known as dextroamphetamine, this is a short-acting medication.
    • Evekeo: This is an amphetamine sulfate.
  • Dexmethylphenidate-based medications
    • Focalin: This is an immediate-release version of Dexmethylphenidate, commonly used for short-term symptom management.
    • Focalin XR: This is an extended-release form of Focalin, which can provide all-day benefits.
  • Lisdexamfetamine-based medication
    • Vyvanse: Vyvanse is a long-acting medication whose active ingredient converts into amphetamine when metabolized.

Anti-depressants

Antidepressants may be used to treat ADHD, though it is not as common, as it is not a first-line treatment option. They can be effective for individuals who are living with co-existing mood disorders. Medications are tailored to each individual, which commonly contributes to variations in the medication’s use, dosage, and frequency.

  • Bupropion
    • Wellbutrin: Wellbutrin may be used with those experiencing co-existing depression. 
  • Tricyclic antidepressants (used rarely)
    • Imipramine: This medication can be used to target mood and ADHD symptoms.
    • Desipramine: This may be considered in some cases.

Non-stimulants:

Non-stimulants are commonly used with individuals who struggle with stimulants or do not experience clinical gain from stimulants. Non-stimulants are generally slow-acting compared to stimulants, which means that they address ADHD symptoms differently. As with many medications, it may take time to find the medication and dosage that is right for you.

  • Atomoxetine
    • Strattera: Strattera is a norepinephrine reuptake inhibitor that is commonly used with individuals who experience heightened levels of anxiety symptoms.
  • Guanfacine
    • Intuniv: This is an extended-release medication that can help decrease impulsivity and hyperactivity, and improve emotional regulation.
  • Clonidine
    • Kapvay:  Kapvay is an extended-release form of clonidine. This medication is commonly used to address sleep disturbances associated with ADHD.
Request A Call Back

Complete the form below to receive a prompt call back from a member of our experienced and compassionate admissions staff. All communication is 100% confidential.

"*" indicates required fields

By submitting this form you agree to the terms of use and privacy policy and give my express written consent for AMFM Healthcare to contact me at the number provided above, even if this number is a wireless number or if I am presently listed on a Do Not Call list. I understand that I may be contacted by telephone, email, text message or mail regarding my disability benefit case options and that I may be called using automatic dialing equipment. Message and data rates may apply. My consent does not require purchase. Message frequency varies. Text HELP for help. Reply STOP to unsubscribe.

Disclaimer

What Are ADHD Treatment Programs Covered by Aetna Insurance?

Aetna health coverage options commonly include a range of ADHD treatment options. Inpatient treatment, outpatient therapy, intensive outpatient programs, and partial hospitalization programs are commonly included. The terms and limits of your coverage are based on the details of your policy. Mental health treatment programs are tailored to your unique needs to help decrease your psychological distress.

Your policy may require that you receive care from in-network providers, or require prior authorization for some programs. Aetna coverage includes access to evidence-based practices that have proven to effectively treat ADHD.

Aetna Insurance Coverage for Residential Inpatient ADHD Treatment

Residential treatment programs can provide you with a structured environment around the clock. Here, you’ll have access to professional support and guidance 24/7, ideal for moderate to severe mental health concerns. Residential treatment programs commonly include therapy, counseling, peer support for ADHD, and medication management services.

Aetna generally provides coverage for residential and inpatient treatment programs for those who experience significant psychological distress from their symptoms. This occurs with individuals with co-existing conditions.

Aetna Insurance Coverage for ADHD Intensive Outpatient Program

Intensive Outpatient Programming (IOP) includes structured treatment for a minimum of nine hours, over several weekdays. IOPs focus on behavior management skills, learning coping strategies for ADHD, and medication management services. These sessions are often available in morning and evening sessions to accommodate professional, academic, and personal responsibilities.

Aetna health coverage options typically include IOP treatment. Your coverage is dependent on the details of your policy and may require prior authorization to initiate the medical claims process.

Aetna Insurance Coverage for ADHD Outpatient Program

Outpatient ADHD programs are a flexible treatment option that can include weekly or biweekly therapy sessions. Many treatment centers offer medication management services and psychiatric care. Your treatment will focus on evaluating the effectiveness of your ADHD coping strategies and making adjustments to improve your overall functioning.

Aetna insurance plans often include coverage for outpatient treatment This can include individual therapy, group therapy, and medication supervision.

Aetna Insurance Coverage for Partial Hospitalization Program for ADHD

Partial Hospitalization Programming (PHP), also known as day treatment programs, provides a full day of therapeutic services. This commonly includes therapy, counseling, skill building, behavioral modification, and life skills development. This is an intensive treatment option, similar to an inpatient program. The key difference between the two is that PHPs allow you to live at home.

Aetna health coverage options typically provide coverage for a PHP. Your policy may require that you obtain prior authorization before engaging in treatment services.

What Types of ADHD Are Covered by Aetna Health Insurance?

There are several presentations of ADHD, each of which can include varying symptoms. Your treatment provider will determine which type of ADHD you’re living with so that they can provide you with effective treatment. Aetna generally provides coverage for varying types of ADHD, including, but not limited to:

Predominantly Inattentive Presentation

Predominately inattentive presentation of ADHD is known for causing difficulties with focusing, organization, and paying attention to detail. This may appear as being forgetful or easily distracted by others. You may find yourself struggling to follow directions. You may not have the typical hyperactive symptoms associated with ADHD, which can disguise your ADHD symptoms.

Aetna typically covers treatment for inattentive ADHD. Your coverage can include therapy, behavioral interventions, and ADHD medications.

Predominantly Hyperactive-Impulsive Presentation

Predominantly hyperactive-impulsive presentation of ADHD can lead to excessive movements and impulsivity. You may find it challenging to sit still, act without thinking things through, or interrupt others during conversations. This is more common among children, though it can continue through adolescence into adulthood.

Aetna health coverage options can include coverage for the hyperactive-impulsive presentation of ADHD. Your coverage is dependent on the details of your policy and may require prior authorization.

ADHD with Co-occurring Conditions

ADHD can co-exist with conditions like anxiety, depression, bipolar disorder, learning disabilities, behavioral disorders, and substance use disorders. Co-occurring conditions often require complex and personalized treatment, potentially on a long-term basis. Treatment can include therapy, counseling, skills development, and medication management services.

Aetna coverage often incorporates coverage for co-occurring disorders. Coverage may depend on the results of a comprehensive evaluation, and come with out-of-pocket expenses.

Combined Presentation

Combined presentation of ADHD can include both inattentive and hyperactive-impulsive symptoms. You may find yourself struggling with your focus, organization, and restlessness. This is the most common form of ADHD. Treatment recommendations vary for different severities and can include counseling, therapy, and medication management services.

Aetna coverage typically includes combined type ADHD. Your coverage may require prior authorizations for maximum coverage.

How Much Does ADHD Treatment Cost Without Aetna Insurance Coverage?

The average cost of ADHD treatment near you without insurance is dependent on the type of care you receive, use of specialized services, the location of the facility, and the experience of your therapists. There are significant differences between residential and outpatient treatment costs. Inpatient costs range from $500 to $2,000 per day, including fees for room, board, and meals.

Traditional outpatient therapy sessions are often $100 to $200 per session, with lower rates for group therapy sessions. Specialized outpatient programs, including PHPs and IOPs, have higher expenses due to the intensity and frequency of their treatment. It is important to note that these prices can fluctuate greatly in different areas of the United States, which is why we recommend that you contact AMFM directly for a personalized quote regarding treatment costs.

  • The Centers for Disease Control and Prevention (CDC) indicated that 15.5 million adults were living with an ADHD diagnosis, half of which were diagnosed as adults.
  • The average age of onset for ADHD is six years old. Children living with severe cases of ADHD may be diagnosed as young as four years old.
  • The prevalence of ADHD rose from 6.1% to 10.2% in adults between 2022 and 2024.  This has led to a notable increase in the number of adults seeking treatment for ADHD.
  • Rates of ADHD among adults are higher among those between the ages of 25 and  29. ADHD rates decrease as age increases.
  • ADHD treatments used with adults commonly include medication management services, counseling, improving interpersonal relationships, lifestyle changes, and increasing support.