There are a lot of ways ADHD can cost you money. It can derail your career, or it can wreak havoc on your personal finance management. But the most direct way it can come for your pocket book is through medical expenses.
How much you have to pay for the privilege of having a mental health condition treated depends on what country you live in and how its health insurance system works.
So let’s set that to one side for a minute and start with a more basic question: separate from the question of who’s paying for medical care, how much more does medical care cost for someone with ADHD?
A recent study looked at this question by analyzing four million member records from Germany’s national health insurance database (more on this in a minute). It found that people with ADHD cost about €1500 (currently around $1700) more per year, with that money going to medications, psychiatrists, psychotherapists, and so on. When the researchers included comorbid conditions like anxiety or depression, that figure rose to €2800, or currently around $3180.
Now, these numbers are specific to Germany, so it’s worth taking a minute to look at how health coverage works in Germany. Most people in Germany receive publicly financed health insurance through non-profit insurance providers. Which is partly how the authors of this study had so much data to work with, through the country’s insurance database.
Medications and medical services generally have different prices depending on how health care is organized in a given country. For example, per capita spending on prescription drugs in Germany was $686 in 2015. In the United States, it was $1,011.
The other thing that varies by country is where the money for medical care comes from. The United States, with its private health care system, is unusual in that people pay especially high out-of-pocket costs. People with ADHD often feel this burden directly when they fork over cash for treatment costs under their insurance plans or they have to go “out of network” to get adequate treatment.
Regardless of the specifics of how health insurance is set up, the study by the researchers in Germany highlights one fact that remains constant: people with ADHD are going to have higher medical costs. That’s not a surprise, of course, since people who have medical conditions by definition require more medical care than people who don’t.
Even if this fact is obvious, it’s important to keep in mind. Recall that in not-so-distant history, insurance companies in the United States had the right to deny coverage to people with “preexisting conditions.” If we go back to that system, which some politicians have expressed an interest in doing, people with ADHD are screwed.
Why? Because, from an insurance company’s perspective, people with ADHD cost more. If they have the choice to do so, for-profit insurance companies will always try to shift that cost onto patients with ADHD.
In the United States, people with ADHD are already paying a significant portion of that cost – thanks to high deductibles, cost sharing, and other things that are really just fancy ways of saying “how we screw over people with medical conditions.”
To the extent that it’s possible, you try to work the system to keep your ADHD medical costs down. You get the referrals you need, you stay in network – and, unfortunately, sometimes you forego treatment.
At the end of the day, though, medical care for people with ADHD is always going to cost more. The extent to which individuals with medical conditions they didn’t choose to have are expected to shoulder the burden for their own medical care is a decision we make about how to organize the system, and people with mental health conditions are then left to deal with that decision.
On that cheery note, feel free to leave your ADHD health insurance horror stories below!