I’ve decided, I’m getting evaluated

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That means your family has $13,000 / year of coverage and you pay nothing out of pocket.
That sounds really great, assuming your family hasn't used up a lot of that money already.


Things to consider:

1)

Is that for medical psychiatry, social workers, psychology, or psychotherapy?

Double check what the provider's credentials are, and what this insurance company covers.
Here it's rare for insurance to cover psychotherapists.


2)

Confirm which credentials are required for a legal ASD diagnosis in the state where you live.
I've heard of people getting a professional diagnosis which is later discredited by their state.

You might someday want to use your diagnosis for work accommodations or disability pay.
If it's the wrong credentials, it may not be considered valid.

* One work around I've heard:
Some places will validate "unaccredited" written diagnoses if the report gets signed by a medical doctor.
I've heard of people getting their report stamped and signed by their GP.
If needed, double check if this pertains to where you live.


3)

The year they refer to may be 2022, or it may start / end at a different time.
My insurance year starts and ends 31 August.
That means I could spend my whole amount on 31 August, and again on 1 Sept.
I actually managed to straddle my daughter's ADHD assessment so we could use both years.
It was like double-dipping with careful appointment / calendar planning.

If your family's $13,000 is almost maxed, see when the new insurance year begins.
You likely have to wait quite a while for your appointment anyway.


4)

To be on the safe side, send a written estimate of the assessment fee to your insurance.
They should be able to tell you what will be covered or not.

Thank you so much for all of this information. I contacted my insurance and confirmed that I am covered for an evaluation. They confirmed that I would only need to pay a $30 dollar copay for each visit. I am covered up to that limit for the entire evaluation, according to her. I found someone who does adult evaluations as well at my therapist office. It seems I’ve gotten really lucky and I am very grateful. I had her send me an email confirming this was the case in case I run into trouble.

Update: I called, I have a 3 hour evaluation on September 1st at 0900 am.

Last edited by Brainiac42 on 12 Jul 2022, 9:05 am, edited 2 times in total.

That's excellent!

Even though I'm on GHI/Emblem, I wouldn't be covered for an autism evaluation.

Good luck!

Oh yes, also thank you for your help as well, and everyone else who has commented here. I will report back either way on how the assessment goes. I edited the post above but I have a 3 hour assessment on September 1st at 0900.

I hope it goes well for you.

Thank you. Since it’s the same therapist office where I go to therapy I’m hoping my therapist can give him (the evaluator) my files as well.

I too have been considering it. My psychologist thinks it isn't worth it and that the tests are too prone to an incorrect result. I'm unsure about the latter part, but I do think a proper diagnosis would be worth it. It would open the door for accommodations at work, should the need arise (unless the need arose, I wouldn't disclose my diagnosis at work). It would also give me peace of mind and be helpful when continuing down the path of developing my comfort and effectiveness with social situations. If nothing else, I'd probably have a better handle on whether I'd be biting off more than I can chew in certain situations.

I would go for it if you think it could help you at all. Even just for peace of mine, to stop imposter syndrome.. or to know once and for all. I am doing it for the possibility of accommodations in school (I don’t need them at work so far as I work at home, quiet office job) and also self discovery/help with my relationship. If it turns out the evaluator does not think I have Autism then I will continue down this path of self discovery to try and determine what makes me different. My parents tell me it doesn’t matter, because I’m me regardless and I’m fine the way I am. I agree, but I’d like to know more about myself also. I’ve struggled in school my entire life and needed accommodations all throughout school but was not diagnosed with anything.
My drivers Ed teacher tried to tell my dad to get me tested for ADHD because I was struggling driving/not focusing like other students. I don’t really have attention issues. My dad got angry and denied it. I’ve got a clean slate, was just in remedial classes except for AP English. I need accommodations, and learning who I am will help me navigate. If any of this is relates me to you I would recommend if you can afford it. From what I’ve been told it’s usually expensive.

I've got my evaluation scheduled for the end of September. As you say, I'm just doing it for peace of mind so that I'll know one way or the other for sure. I've made it this far in my life without knowing but I've always found that I can make better decisions if I have better information so I'm going to do the evaluation just to see what new things I can learn about myself. It should be enlightening.

be prepared for anything. I was given a book about 'how to live independently' and they talked to me like I am three years old. I was not happy about that.

It's good to know, but government agencies might put 'intellectual disability' on your records if you do bad at the IQ test.

They make you do an IQ test??

I think it depends on how much question there is about your mental faculties.

I gave my assessor a big pile of records, including report cards, college transcripts, standardized school tests, résumé, etc. She raised the possibility of skipping the IQ test.

With a child they probably need to see how "functional" they are.

I mentioned a reason for getting a diagnosis as needing accommodations for school. My grades in middle school/high school starting in 6th grade were awful. I started having some learning issues in elementary school but they just stated it was disorganization. I was in remedial math courses in middle/high school. I am very good at memorization and writing. It takes me longer than average to comprehend text (I am hoping for extra time in tests) and I am very bad at math. I wonder if they will have me do an IQ test. I am curious because I am very gifted in certain areas and very bad in others. For example: Very good at visualizing in my mind/memorizing terms quickly.. very good at short term memory especially. Terrible at math, and I often have to reread things 2-3 times to fully grasp it, but when I do I can heavily visualize it in my mind. It’s odd.

Last edited by Brainiac42 on 13 Jul 2022, 11:44 pm, edited 1 time in total.

Part of my assessment included WASI-II, The Weschler Abbreviated Scale of Intelligence.
It wasn't a full IQ test but enough for them to measure verbal vs non-verbal IQ.

Academic fluctuations like you describe could also be indicative of ADHD.
On my ADHD assessment they looked at all my school reports to see if my grades went up and down.
My daughter's ADHD report has pages of academic recommendations.

Ahh ok. A drivers Ed teacher of mine thought I may have ADHD as I couldn’t pay attention to the road well/was very hyper and talkative. The thing is, I can hyper focus on my interests for hours. I only have attention problems when the material is boring.. I often have trouble focusing on material that isn’t a hyper focused interest at the time, or just isn’t an interest at all.. but I CAN, if I have to. As I’ve gotten older and I’m less hyper I really don’t see ADHD in myself, even though it’s hard to focus on boring things. I definitely see it in my mom though. My grades stayed consistently bad, I only did well in English. The person doing my evaluation is trained in all kinds of disorders, who knows maybe he will pick up on something.

I didn't think I had ADHD either.

The combination of ASD and ADHD is quite a clusterf**k because people can hyper-focus or get obsessed with special interests (ASD), but also have trouble multitasking or shutting off their brain (ADHD).

I always thought ADHD meant that the person is physically hyper but in my case it's just my brain. If it's hyper about the right topic I can get a lot done, but if it's hyper at the wrong time I end up being scattered. I guess I do wiggle and fidget a lot as well, but I always thought that was ASD stimming or BFRBs. Turns out they still count as ADHD motor movements.

I'm sure your report will have lots of recommendations for you as a student, whether they test for ADHD or not.