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ADHD & Anthem

Adult ADHD care, covered by Anthem.
Evaluation, diagnosis, and ongoing treatment.

Anthem is the carrier we are contracted with most broadly in Virginia, and adult ADHD is one of the most common reasons people book here. This page covers how the two fit together.

The short answer

Yes, and here is what that actually means

Adult ADHD assessment and treatment are covered medical services under Anthem behavioral health benefits in Virginia. What you pay depends on your specific plan’s copay and deductible, not on the diagnosis.

What tends to confuse people is that ADHD care has two separate insurance questions running at once. One is whether your visits are covered. The other is whether a particular medication is covered. Those are handled by different parts of your plan, and the answers can differ.

What the process looks like

From first call to steady treatment

01

Start with a free screener if you want

The adult ADHD self-assessment on this site is scored in your browser, saves nothing, and costs nothing. A positive result means an evaluation is warranted, not that you have ADHD.

02

Comprehensive evaluation, 60 minutes

A real diagnostic conversation covering symptom history going back to childhood, current functioning, sleep, mood, and anything medical that could look like ADHD. Billed to Anthem as an initial psychiatric evaluation.

03

Rule out the look-alikes

Anxiety, depression, sleep apnea, thyroid problems, and chronic sleep deprivation all produce attention symptoms. Treating ADHD that is actually untreated sleep apnea helps nobody, so this step matters.

04

Treatment plan and, if appropriate, medication

If stimulant medication is indicated, we discuss the options, the risks, and the monitoring involved. Non-stimulant options exist and are sometimes the better fit.

05

Ongoing follow-up

Controlled medications require regular visits. These are shorter appointments, billed to Anthem, and they are how dosing gets adjusted to actually fit your life.

The medication question

Prior authorization, formularies, and shortages

This is where most of the friction lives, so it is worth being direct about it.

Frequently Asked Questions

Does Anthem cover an adult ADHD evaluation?

Yes. An initial psychiatric evaluation is a covered behavioral health service under Anthem plans in Virginia. Your cost is your plan’s copay or the contracted rate applied to your deductible.

Do I need neuropsychological testing first?

Usually not. Adult ADHD is diagnosed through a thorough clinical interview and validated rating scales. Full neuropsychological testing is expensive, often not covered, and is generally reserved for complex cases where another condition needs to be sorted out.

Will Anthem cover my stimulant medication?

Coverage depends on your pharmacy benefit rather than your medical benefit. Many plans require prior authorization for adult stimulant prescriptions. We submit that request, and it typically takes a few business days.

Can I get diagnosed by video?

Yes. The evaluation is conducted by secure video anywhere in Virginia. Video is also what current federal rules require for prescribing stimulant medication, so it is the standard here rather than the exception.

I was diagnosed as a kid and stopped treatment. Do I need a whole new evaluation?

Yes, but it is usually straightforward. We still need a current evaluation to prescribe, and childhood records help. Bring whatever documentation you have.

What if I do not have ADHD?

Then you leave with an answer, which is worth something on its own. A meaningful number of people who come in convinced they have ADHD turn out to have anxiety, depression, or a sleep disorder, all of which are treatable, and none of which respond to stimulants.

Related pages

Free 2-minute ADHD screener How ADHD evaluation works Getting an adult ADHD diagnosis About adult ADHD Anthem BCBS Anthem HealthKeepers Every Anthem plan we accept
Ready when you are

Attention problems are worth an actual answer.

Adult ADHD evaluation and treatment, in network with Anthem across Virginia. No referral needed.

A note on urgency

If you are in crisis right now, please do not wait for an appointment.

Call or text 988, the Suicide & Crisis Lifeline. Free, confidential, available 24/7.
For emergencies, call 911 or go to your nearest emergency room.

Alice Tran Psychiatric Care does not operate 24/7 and does not provide crisis services. Emails, voicemails, text or portal messages are typically responded to within 24 to 72 business hours.