Not meeting the criteria...

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I sorta feel like i need it to validate the source of my weirdness. the cost is prohibitive. other than that, there's not much downside. for me, i'm good with self diagnosis, but i'm to the point of wanting to be able to explain to others that i am trying not to be rude, but that my brain structure does not allow me to react differently than i do.

I have been diagnosed with severe ADHD inattentive, but i'm seeing a lot of autistic traits as i research autism. i believe that i'd be diagnoses as having Asperger's if the DSM5 still had that designation.

my adhd has caused some limitations and i'm sure that being on the autistic spectrum has caused other limitations. but, i don't really see either as a disorder, but rather a different brain structure. i love the way my mind works most of the time but i hate the amount of inescapable anxiety i can feel at times.

I'm guessing that you are old and established enough that a diagnosis would not hurt you...other than perhaps in your wallet. So, the issue would be your wallet.

When I decided I would like an Adult Autism Assessment one of the first things I did was call my health insurance's Nurse Advice Line to request a referral to someone who could perform the assessment. They said they could only give me a referral if it was an emergency and it didn't sound like one so I should go through my Primary Care Provider (PCP). I made an appointment but it was a month in the future. Coincidentally, however, my bride had the same PCP and already had an appointment with her that was sooner than mine; at her appointment my bride said I would like a referral for an Adult Autism Assessment and she said our PCP immediately got on their computer and made the referral. (I'm not sure how to interpret that the PCP did not ask any questions or express any doubt...she immediately setup the referral!)

I then tried working through my insurance company to get a suitable provider. Sigh. They were eager to help but it turned out they did not know what they were talking about! None of the leads they gave me panned out and I started scouting on my own, and finally got a call back from one place who told me what I really needed to find: a licensed psychologist who worked with Autism (and took patients my age) who was willing to do an Adult Autism Assessment (my insurance company had listed some other apparently incorrect criteria to satisfy).

I found a suitable provider and got my Adult Autism Assessment...which was actually kind of fun!

And I got my diagnosis: Autism Spectrum Disorder, Level 1 (Mild)—with a note that I also satisfied the criteria previously associated with Asperger's Syndrome.

In all of the confusion talking to my insurance company I ended up going with a psychologist who was not in their network. And by that time, in addition to my insurance company I had also gotten onto Medicare. As I recall I ended up paying for about half the cost of the assessment. I don't know whether I could've done better by staying "in network" for my insurance company.

But I didn't care! I was so happy to get the diagnosis I almost didn't submit it to insurance for any reimbursement! I finally knew why people were strange!

i actually started searching for someone who'd take medicare for an evaluation a couple of years ago. no luck. i'm guessing the full cost would be out of pocket. I've heard a range of estimates that, from what i remember could be $1200 - several thousand dollars. i think i could swing $1200 if need be, but the open endedness of potential costs and the strain of the whole process escalates my anxiety... a lot.

i've decided to work with my therapist, who cannot diagnose me, but i'm hoping will be able to help establish a likelihood of a diagnosis were it to pursue it. it would be pretty tough to spend the time and money and then find out my self diagnosis was just a case of confirmation bias from what i'm reading onlne. i think i'm slam dunk autistic, but i'm still doing the research.

When I got my diagnosis I had to pay the psychologist myself. But then I submitted the bill to Medicare for reimbursement and they sent me a check (smaller than what I paid the psychologist); then I submitted to my health insurance for reimbursement for the portion Medicare did not cover.

I still ended up paying for about half the original bill. But, like I said, I was "out-of-network" for my health insurance. I don't know if staying in-network might have saved me more money.

Another way I saved some money is that after learning about me the psychologist offered not to do the IQ test which she would have normally done as part of the assessment. I belong to Mensa...while I don't know what my IQ is, it had to be in the top 2% for me to get into Mensa.

Besides figuring out all of that nonsense, another distraction for me was finding someone to do the assessment. After I got past the incorrect information my insurance company had given me I knew I needed a licensed psychologist who worked with Autism, took patients my age, and who would do the Adult Autism Assessment.

I used https://www.findapsychologist.org to find psychologists in my area who worked with Autism and with people as ancient as me. But I could not find one whose listing said they did Adult Autism Assessments. I figure there must not be much business there so they don't bother mentioning it in their listing. So, I had to go to the web page for the psychologist...and, again, no mention of Adult Autism Assessments...presumably the same reason. But I found a nearby practice that apparently worked with Autism and with patients as old as me and I telephoned them.

The person who answered the phone (office help, not a psychologist) did not think they did Adult Autism Assessments but wasn't sure. Fortunately she checked. They did my assessment.

It was kind of fun!

P.S. Good luck!

I appreciate the feedback. I'll check out the link. Can you give me a ballpark of what my costs might be if totally out of pocket? I won't count on it as gospel truth, but it'll give me some indication of what to expect.

Be sure you check with your insurance company for their rules (I guess that even applies to Medicare). I'm guessing a referral from your Primary Care Physician would be useful.

Good hunting!

thanks. I will

I will be surprised if they pay everything...but whatever they pay should be a pleasant surprise.