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$Cost of treatment question

$Cost of treatment question2013-06-11T14:03:30+00:00

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  • #120529

    Post count: 48

    It’s been a while since I posted, life got really hectic with trying to stay afloat with work, give my new puppy the attn he needs, and maintaining my relationship with my boyfriend, who I just moved in with and who also has ADHD.
    I found out yesterday that the NP who had been prescribing for me for the last 5 yrs, no longer feels comfortable doing it via email. I can’t blame her, it is probably a huge liability.
    I was able to make an appointment with a Dr who specializes in ADHD and is board certified in psych and neurology. He doesn’t take insurance. I have learned that a lot of the best people to see for this don’t. I am willing to pay out of pocket for this. It is too important not to seek good care.
    My question is for those who have been paying out of pocket for what they consider good care that they cannot get elsewhere for cheaper.
    How much do you pay for the initial visit and then for subsequent appointments?
    This one charges $400 for the initial 90 minute eval. After that it’s $200 for each subsequent one.
    I have never had a real eval and am diagnosed with bipolar disorder so don’t have time for treatment that will either not help or will cause harm. Is this much more than others charge? Have you found the high cost worth it?


    Patte Rosebank
    Post count: 1517

    @Galadriel724, that’s about the going rate, I’m afraid.  Even in Canada, where we have socialized medicine, psychologists and coaches are not covered.

    In fact, the initial assessment can often cost $1600, because it involves a thorough diagnosis, which takes several hours of interviews and various types of tests.  It sounds like this new specialist is foregoing that intense process, because you were previously diagnosed and have been getting treatment for it, for many years.  So, the 90-minute intake assessment is for the doctor to familiarize himself with your case and to assess the current state of your general health.  This is how it was for me, when I first began my treatment.

    Many ADHD symptoms overlap with Bipolar symptoms, so a lot of ADDers are initially diagnosed with Bipolar, Bipolar II, or Depression.  And it’s very possible to have any of these as co-morbidities with ADHD…or not to have them at all.  The doctor will investigate all this during the intake appointment, and may either confirm or reject the previous diagnosis.  The whole point of it is to look at your symptoms on a lifelong basis, and rule OUT possible causes (both physical and mental), in order to reach a diagnosis.

    The important thing is, this new doctor specializes in ADHD, so he has the knowledge and experience to help you.  That saves you the frustration of wasting time and money on a general psych. who has no clue about ADHD.

    ADHD treatment is most effective when it involves a combination of meds and behavioural therapy (such as coaching).  So, you may move towards a program of monthly or bi-monthly visits with the doctor (to monitor the meds and your health) and more frequent sessions with an ADHD coach.  Many coaches charge much less than $200 per session, and they offer coaching by Skype, so you could have a coach anywhere in the world!

    The relationship between you and your doctor is a hierarchical one.  The relationship between you and your coach is more equal.  The coach helps you to re-frame things, so you can work out solutions together, and find the right questions to ask your doctor and others who can help you.  And the coach gives you unconditional encouragement…as you may wish your family and friends would!

    Discuss all this with your new doctor, and ask about coaching as part of your treatment.  With his expertise, he can answer a lot of your questions better than I can.



    Post count: 48

    I decided to cancel for now, after I thought it through. I can always make another appointment. I got the price list. He charges in $125 chunks, even if I just have a question about a side effect.
    The other reason is pretty basic. If he changes my meds, and something needs tweaking/adjusting on a weekly basis, I can’t afford him. 60 min eval $495. 90 min eval $795. This is also the price he charges for refills and every other visit.
    I am a psych nurse and the psychiatrist I work with is really awesome. I’m going to see if she can recommend someone. I’ve been stable on the same meds for 3 yrs and wouldn’t be looking to change anything if I didn’t need to find a new prescriber. I have a 2 month head start too. I won’t go through my insurance company, because of the headache and the fact that most psychiatrists here don’t deal with insurance, but I have my limits. I would pay that much for an eval, but I’m pretty low maintenance and don’t want to have to check my bank balance if I have a side effect question…

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