Diagnosis and management of ADHD:

  • GP consult, probably many of them. Let's call it one @$50 with a referral to a psychiatrist (they are the ones that make the formal diagnosis)
  • The Psychiatrist is either public (up to a two-year wait as not urgent) or private with a $400 initial consult cost.
  • From there, you probably have a second follow-up on this for another $250.
  • Once diagnosed and the special authority for medication is sorted, there's the specialist prescription at $35 initially.
  • From there, you need to either go back to your GP for a follow-up and confirm the ongoing medication approach. Another $50 (or skip this and continue with the Psychiatrist's scripts)
  • From there, monthly scripts cost $25 to $35 for the script
  • $15 for the pharmacy
  • Depending on your specialist and GP, another $50-250 at month three for a check-up and three monthly thereafter. You understand why people move to their GP reasonably quickly.
  1. If we add that up, assuming no pharmacy subsidy kicks in, the first-year out-of-pocket cost is: $1,265
  2. For the second year, it's a little better; no psychiatrist, it's a more palatable $580.
  3. Year three gets interesting, though, as the special authority for the meds needs to be renewed. This is another trip to the Psychiatrist and $250 for that review.
  • So alternating $830/$580 per annum is ongoing.

This adds up, especially as those with ADHD typically have a more challenging time with jobs and relationships than their financial position.

So what's the insurance response?

Back to the original article

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