With NHS waiting lists for ADHD and autism assessments only getting longer, you might be hoping that your Bupa policy holds the answer to faster results.
While most insurance providers exclude neurodiversity assessments from their policies, some do offer them as part of specific workplace packages. So, it’s worth asking: will Bupa cover an autism assessment? And can you get an ADHD diagnosis on a Bupa plan?
To help you get the answers you need, we’ll look at whether Bupa covers ADHD assessments, if it covers autism assessments, and how to find out what your specific policy includes.
Does Bupa Cover ADHD Assessments?
In short, no. Bupa does not cover ADHD assessments within its standard private insurance policies. However, that doesn’t mean you can’t get an ADHD diagnosis through Bupa at all.
If you have Bupa insurance through a workplace or corporate scheme, there is an optional add-on called the Neurodiversity Benefit. You can get an ADHD assessment through this pathway, provided your workplace has chosen to include it within the workplace plan.
To qualify for the Neurodiversity Benefit, you’ll still need to get a GP referral for an ADHD assessment. Your employer’s scheme also needs an outpatient allowance of at least £1,500 per employee.
Will Bupa Cover an ADHD Assessment If You Have Mental Health Cover?
No, Bupa doesn’t include ADHD assessments within its mental health cover. However, it can cover treatment for mental health conditions commonly linked to ADHD, such as anxiety or depression, even though ADHD itself is excluded.
Studies show that 80% of people with ADHD will have at least one psychiatric disorder in their lifetime, with anxiety and depression being the most common — this is where Bupa can help.
Treatment for anxiety and depression is available through Bupa’s mental health cover. Cognitive behavioural therapy (CBT), short-term psychodynamic psychotherapy and a range of talking therapies are all included.
Unlike the Neurodiversity Benefit, mental health cover is included as a standard part of Bupa’s health insurance, meaning you don’t need to add it on to be covered.
Does Bupa Cover Autism Assessments?
No, Bupa doesn’t cover autism assessments within its standard private health insurance policies.
Some corporate or employer health schemes can include an autism assessment, but it’s through the optional Neurodiversity Benefit add-on. If your employer opts in to this benefit, you may be able to get an autism assessment through this pathway.
Check If Your Work Scheme Includes Bupa’s Neurodiversity Benefit
Bupa offers an optional paid add-on for corporate schemes that does cover assessments for conditions such as ADHD, autism, dyslexia, dyscalculia and dysgraphia.
The add-on is called the Neurodiversity Benefit. To qualify for this, the business will need to have mental health cover in place, have 50 or more employees registered on the scheme and a minimum outpatient allowance of £1,500 per employee.
The easiest way to find out whether your employer has opted in to this scheme is to ask HR or the benefits team at your workplace.
How Referral and Pre-Authorisation Work
If your employer has opted in to the Neurodiversity Benefit, you may be able to access ADHD and autism assessments through Bupa. To do this, you’ll need to follow these steps:
- Book an appointment with your GP to discuss a referral
- Once you have a referral, get in touch with Bupa, who can pre-authorise an assessment through a named provider, usually selected by Bupa
- Book in with the provider specified by Bupa
Once you’ve booked and attended your assessment, it’s just a matter of waiting for your results. Wait times vary depending on the provider used.
How to Check Your Bupa Policy Before You Book
It’s important to check whether your Bupa policy covers ADHD and autism assessments before you book.
You should have been given a membership guide when you took out your insurance policy. If your cover is through work, ask HR or check Bupa’s online member portal. To be sure what you are and are not covered for, do the following:
✓ Read the exclusions section for any mention of ‘behavioural and developmental conditions’
✓ Look for the Neurodiversity Benefit within the benefits table
✓ Call Bupa and ask them directly: “Does my policy cover a diagnostic assessment for ADHD or autism?”
✓ Get any pre-authorisation in writing, including the provider’s name
✓ Check your renewal date, as cover can change at this time
If you can’t find your membership guide, a copy should be available on your online account. You can also request a replacement from Bupa customer service.
Why Do Bupa Policies Exclude ADHD and Autism Assessments?
Many private insurance providers across the UK exclude ADHD and autism assessments from their cover. Just like Bupa, they’re often only included in optional add-ons or specific premium packages. But why is it so common? The reasons include:
Developmental Conditions Sit Outside Standard Cover
Most standard UK private health insurance is designed to cover acute conditions. An acute condition is a short-term illness that comes on suddenly and can be cured with treatment. For example, a broken bone, flu, appendicitis or a heart attack.
Autism and ADHD are lifelong neurodevelopmental differences. They’re present from childhood and aren’t something you ‘recover’ from, so they don’t fit the acute model insurers build around.
As they’re not considered an acute illness, most insurers will classify autism and ADHD outside of their standard scope for cover.
Pre-Existing Condition Clauses Apply
As autism and ADHD are both present from childhood, they’re usually considered a pre-existing condition.
Most insurers include a pre-existing condition clause in their cover, meaning your insurer won’t pay for treatment of a condition you already had or have recently sought advice for. Time frames vary from provider to provider, so check your policy for specifics.
Even if you only started to suspect ADHD or autism after taking out your policy, the signs were likely present before, so insurers usually treat it as pre-existing. As such, it’s unlikely to be covered within a standard insurance policy.
The ‘Rule Out’ Route Has Closed
Bupa used to offer an exception to its exclusion of developmental conditions, which would allow a diagnostic test to rule out ADHD and autism when a mental health condition was suspected.
However, Bupa removed this exception from its cover in 2024, meaning you can no longer use this route to get a diagnosis.
Other Ways to Get an ADHD or Autism Assessment
You can still get an ADHD or autism assessment, even if your Bupa insurance doesn’t include it within your policy. The three common pathways are the NHS, Right to Choose and going private.
NHS
To get an NHS assessment, you first need to speak to your GP. They’ll ask about the signs of the condition you’ve been experiencing before referring you to a local specialist for ADHD or autism.
It can be useful to keep a diary of the signs you’ve noticed, including when and where you spotted them. When you get to the appointment, you can use this as a reference for the GP.
Right to Choose (England Only)
The Right to Choose pathway allows you to access an NHS assessment, often with shorter waits than local NHS services.
You’ll still need to get a referral, which means speaking to your GP. However, under Right to Choose, you can let them know you’d like a private provider for assessment. Check that the private clinic is NHS-commissioned first; otherwise, you won’t be able to access them on this pathway.
Right to Choose is only accessible in England. You can only use Right to Choose at the point of referral, so if you’ve already had your first appointment with an NHS service, you can’t switch.
Private Provider
Going private is often the fastest way to access an ADHD or autism assessment. However, if it isn’t covered in your Bupa workplace policy, you’ll need to fund the cost yourself.
When you go private, you can research a clinic near you, or explore online assessment options. Make sure you read the reviews, check what you get included with the assessment and how much the whole process costs.
Speak to Neuroaffinity About Expert ADHD and Autism Assessments
Here at Neuroaffinity, we believe neurodiversity assessments should be accessible to all, which is why we offer ADHD assessments and autism assessments at our private clinic.
If your Bupa policy doesn’t include the Neurodiversity Benefit, you can come to us for fast, professional assessments for adults and children. We can offer an assessment time that works for you in as little as four weeks. Get in touch with us today to see how we can help.
You can reach us on 0776 856 5162 or email us at enquiries@neuroaffinity.co.uk. Alternatively, you can fill out our contact form, and we’ll get in touch with you.
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