Does insurance cover ADHD testing?

[ojpalosa]

I'm a 15F SMK student and I like reading all sorts of things, but about a year ago I was reading an article about neurodevelopmental disorders and noticed some symptoms that I had resonated with, so I did research over the course of a few months (articles, Quora questions, YouTube, even tiktok) and some self-testing (RAADS-R test, CAT-Q test, Ritvo test...etc)

After weeks of contemplating, I consulted my mother about it. My older sibling is also neurodivergent and has depression, and while I don't know the exact details they are seeing a psychiatrist. My mother said it would be quite expensive to send us both to psychiatrists but at that time I didn't know much about the disorder treatment and she didn't either, I just that I knew I had it, so I told her it could wait.

The problem is, it can't wait. I just want a diagnosis and meds to go along with it. Having too many factors of stress that I won't mention is really too much on my plate. If you hold things in too long, you start getting messed up and I'd rather not live with the fact that I'm a ticking bomb ready to explode at any minute. I want to get tested at a government hospital, but I don't know how much it will cost.

My sibling had me take a test recently because they suspected something and was curious, and I ended up pretty high on the autism spectrum, but that doesn't really matter right now. Sorry if you can't help or you hate that I'm posting here, it's just that I don't have anywhere else to go. I don't know what to do because everywhere I read is always talking about the USA.

TL;DR

I want to know if insurance covers ADHD/autismspec diagnosis, and if tests at government hospitals are accessible to teens +a sob story

 

[vmh]

@ojpalosa Insurance companies do not cover ADHD. While AIA expanded their coverage to mental health, ADHD is not covered. But as someone who goes to PPUM regularly, I can tell you that it's quite affordable.

Price at PPUM:
Consultation - RM 15
Medication for 1 month (Concerta + Valdoxan) - 410

Do note that the psychiatric clinic at PPUM is overwhelmed with many patients. If you want to get fully fully diagnosed, I suggest finding a private clinic

 

[mariahksmith11]

@vmh Agreed with this. If you just want the diagnosis to make it easier to convince people of your condition, it's only RM15 at a public hospital. It's the medication that isn't covered.

Managing ADHD while you're young is 80% about developing coping strategies and good habits now. Medication can be an immense help but it will not make up for a lifetime of lack of discipline that's been fostered by ADHD propensity. I have severe ADHD and learned this the hard way

 

[vmh]

@mariahksmith11 I agree with this. @ OP you can look into coping mechanisms WHILE also taking medication. Medication is also important to ensure your performance at work/school gets affected less while you learn how to cope.

For me i still manage to perform well at my job. I don't solely rely on my meds, I also built a work tracker system on Notion and timeblocking my tasks to help keep me on track.

When I was off meds in uni, I really struggled trying to keep everything together. Fortunately graduated with Honours, but if I could get the meds I assume I would've performed way better.

 

[ojpalosa]

@vmh Thanks so much for the info. I'll let my parents know about the diagnosis costs and start looking into coping mechanisms

 

[withbatedbreath]

@vmh I just booked an appointment for klinik kesihatan to get referral letter to see hospital psychiatrist. hearing this should i go for a different hospital?

 

[vmh]

@withbatedbreath If PPUM, I'd say you have to budget around 2 hrs or so from the point of going to the hospital and going out with meds. There was only one occasion where Ritalin was out of stock, but they stocked up really quickly.

 

[withbatedbreath]

@vmh I dont mind waiting as long as I get proper diagnosis tbh. thank you

 

[countvicta]

@ojpalosa Before jumping to any self induced Google based diagnostic, I would suggest just finding a psychologist for a consultation and go from there. It shouldn't cost a limb to get a consultation.

Good luck

 

[vmh]

@countvicta If you read the post, this is what OP is trying to do; to get an actual consultation

 

[countvicta]

@vmh But he's crutching at straws here by worrying about the cost involved before seeking consultation. If he isn't able to get a government specialist then a private one.

I'm trying to say is don't let money be the stumbling block to seeking help. That's why consultations are there, I seen my pts come up to me saying they have a disc prolapse and it's expensive to surgical treat it. Padahal I checked its a pulled back. Cost of surgery is 8k to 15k for disc herniation, cost of a pulled back muscle with consultation & anti inflammatory? 150myr to 200myr.

 

[xsmnt4]

@countvicta I don't think you understand the stress being financially strained enough that even Rm150-Rm200 is very worrying.

And this is what OP is asking exactly, HOW much does it cost to get a consultation be it private or governance. I think if OP or OP's parents has enough disposable income, they wouldn't have asked this in the first place.

 

[vmh]

@countvicta Isn't that what the OP is trying to do? They took some online test and got concerned and wants to get properly diagnosed. The issue here is that their parent might not be willing to finance it

 

[ojpalosa]

@countvicta Like I said in the post, my sibling is receiving treatment that costs $$$ so money is a bit of an issue (that's why I've been asking around to know the prices). Some of the comments have suggested affordable procedures that might help but thanks for your input anyway

 

[countvicta]

@ojpalosa I'm working in the medical industry. I pointed out and emphasised that you need to get diagnosed first. Who knows you are just grasping at straws and you are a perfectly beautiful human being. So take the consult and go from there.

I always get patients like you who are so worried about the treatment cost for an undiagnosed problem by a medical specialist, it stops them from making the first call which is a consultation that costs 100 myr to 300 myr.

 

[ojpalosa]

@countvicta (please read all before replying!)

I know it's not my place to say this as someone who is not in the medical industry, but in complete honesty I fully believe that I'm on the ADD spectrum and I would like affordable treatment so it does not affect my studies (really important for both me and my family so I can get a good job to financially support them).

I'm sorry if I took anything too personally or overstepped any boundaries but I'm sensitive to people who don't believe something that I know is true. I haven't just glanced at a few things on Google, I am aware and share many symptoms with other ND people, and it is currently affecting my school life very drastically to the point of not being "normal", not to mention my teachers' reports on my behaviour at school is don't account for subconscious masking/impression management. I have taken several certified tests online which I am aware isn't an actual diagnosis, but it does make me feel validated and helped me learn more about the condition.

If you don't believe me, that's okay but this should be the end of our conversation. I made the post in the first place seeking help and I have gladly received the help but if you have any more knowledge you can share please let me know! (There are others in these comments who are curious about the procedures, and as someone in the medical industry you should know a thing or two that could help us)

ADDITIONAL INFO (for those in the same situation)

• Someone in the comments mentioned you could get a diagnosis for RM15, but you would have to be put on a long waiting list.

• Medication causes many side-effects, it doesn't just magically cure you but it's meant to be taken to help reduce the effects when you're in public. Researching coping mechanisms is a lot more helpful.

• Alaminda in Shah Alam has been working towards giving affordable treatment to those who less privileged, if you are around that area please give them a call sometime, they might be able to help you.

As a teenager of the female gender in a world where women are less fortunate, most of us are viewed poorly. Any mental issues will be written off as "hysteria", "emotional", "faking it for attention". My school is a public feeder school, where the people who weren't taken to a better school are dumped. A school like that would have its fair share of suicide cases due to high amounts of stress. I simply would not like to end up on the news, and it would be great if others didn't either. Thanks for reading!~ (｡•̀ᴗ-)✧

 

[seets]

@ojpalosa hii I’m a 16F SMK student and I was recently diagnosed with ADHD. having a diagnosis is indeed hard as a poc woman because there aren't too many resources and I waited for a year. even though I got diagnosed I don't have any ND people to hang out with. but anyway I believe in you. and I hope ur doing alright over there

 

[bsstra7]

@ojpalosa Most, if mot all policies will not cover ADD/ADHD as it would be considered a pre-existing condition. If your family is strapped for cash, your best option would be to get checked at a government hospital/centre/PPUM.

Just a couple of notes: The diagnostic process for ADD takes time and government clinics seems to have a backlog of cases to go through so dont expect an instant diagnosis. I would also suggest checking out r/Malaysia if you havnt already as this topic comes up there from time to time.

As a word of comfort, just know that its not the end of the world if you are not able to get your diagnosis at this stage of life. I went through something similair at your age and was only diagnosed with ADD in my mid 20s, but I was still able to get through highschool, university and commence legal training before I was diagnosed.

 

[ojpalosa]

@bsstra7 Thanks so much for the info and words of comfort, but I've seen people suffer from late diagnosis trauma so I'm trying to resolve the issue ASAP. The responses to this post have brought a peace of mind though.

 

[fairydustlady]

@ojpalosa Get a refferal to government hospital psychiatrist. I was treated in Hospital Selayang since I was 13 and making a mess in the house, which was picked up by my mom's psychiatrist. I was reffered and have to pay RM1-5 per visit every 3-4 months and get my Ritalin prescribed for free. I bet I have more taken more than 10k worth of it as now I'm ady 24 yet still taking it.