With lengthy wait times for NHS autism and ADHD assessments, you might have found yourself wondering about other diagnostic pathways that could get you answers faster.
If you have Vitality health insurance, it’s worth considering whether your policy could be the faster option you’ve been looking for. But does Vitality cover autism assessments? And can you get an ADHD assessment through Vitality, too?
In short, Vitality’s standard individual policies don’t cover ADHD or autism assessments. However, some corporate plans might, so it’s worth checking exactly what your policy includes.
In this blog, we’ll answer whether you can get an autism or ADHD assessment through Vitality, how to check whether your policy covers you and what to do if you aren’t.
Does Vitality Cover ADHD Assessments?
Whether you can get an ADHD assessment with Vitality depends largely on the policy you have in place.
Vitality doesn’t include ADHD assessments in standard individual policies, just as most major health insurance providers in the UK exclude them, too. However, if you have corporate or employer-provided insurance, you might be able to get an ADHD assessment through that.
Employer plans can include additional neurodevelopmental benefits that may cover ADHD assessments.
Does Vitality Cover Autism Diagnosis?
If you have a standard policy, it’s unlikely you’ll be able to get an autism assessment with Vitality, as most UK insurers exclude neurodevelopmental conditions from their cover.
However, corporate Vitality health schemes can include both neurodevelopmental and mental health benefits that individual plans don’t. You’d still need to check your coverage, as not every corporate plan will include this.
It isn’t just Vitality that excludes ADHD and autism from its individual policies. It’s actually quite common for health insurance providers across the UK to exclude such conditions for a range of reasons.
Why Do Most Health Insurance Policies Exclude ADHD and Autism?
Structured for Acute Conditions
Most standard health insurance plans were designed for acute medical issues, meaning they come on suddenly and can be treated, such as a broken bone, heart attack or pneumonia.
Autism and ADHD are both neurodevelopmental conditions that relate to how the brain develops, with traits usually present from early childhood. As they’re chronic, lifelong conditions, they’re often excluded from the scope of cover.
Pre-Existing Condition Exclusions
If you had symptoms of autism or ADHD, or sought advice about them, before your policy started, insurers can exclude them as pre-existing conditions.
Even if you didn’t know you had ADHD or autism when you took out your policy, insurers may still treat it as pre-existing, because traits are usually present from childhood.
Higher Costs
Due to the way health insurance works, many insurers consider neurodevelopmental conditions to be too high a financial risk to include in cover.
Assessments need specialist clinicians and often lead to long-term support, which insurers see as high, ongoing costs. As such, this cover usually ends up being excluded from most policies.
Even if your assessment is covered, ongoing treatment and medication usually aren’t, as ADHD and autism are treated as chronic conditions.
Which Vitality Policies May Cover ADHD and Autism Assessments?
While standard individual policies don’t include neurodevelopmental conditions, it may still be possible to get an autism or ADHD assessment through Vitality, depending on your plan.
- Corporate and Employer-Funded Schemes: Some Vitality plans provided by employers include additional mental health and neurodevelopmental cover that might allow ADHD and autism assessments.
- Mental Health Cover Options: If you added Vitality’s optional mental health cover to an individual policy, check exactly what it includes, as assessment cover isn’t the same for every version.
As cover varies so much from one policy to the next, the only way to know for sure is to check your own policy documents or ask Vitality directly.
How to Check If Your Vitality Insurance Covers an Assessment
If you’re unsure whether your Vitality policy covers autism or ADHD and you’re considering an assessment, it’s best to check your policy before booking any appointments.
Your policy documents should set out what’s covered, and you can find those in your Vitality account online or in the app. You can also call the number on your membership card to speak to someone about assessment cover directly.
For those on a corporate plan through work, you can speak to your HR department or benefits team, who’ll be able to let you know what is included in your workplace policy.
To get clarity on your own cover, try asking your HR team or Vitality the following questions directly:
- Is an ADHD assessment covered?
- Is an autism assessment covered?
- Do you cover combined assessments for ADHD and autism?
- If covered, do I need a GP or specialist referral for either assessment?
- Do I need pre-authorisation before booking?
- Is follow-up care or ADHD medication titration covered?
- Can I pick my own provider for the assessment? If not, what clinics are available?
What to Do If Vitality Doesn’t Cover Your Assessment
If Vitality doesn’t cover your assessment, it doesn’t mean you can’t get one. There are a few other assessment options to consider.
NHS
You can get both ADHD and autism assessments for free on the NHS. You’ll need to be referred by your GP for this, so the first step is to book an appointment. They’ll ask questions about the signs you’ve noticed and how they’re impacting you before referring you to a specialist clinic.
Wait times for assessments on the NHS vary by region and condition. For adults, an ADHD assessment in Dorset may take 12 weeks, while an assessment in Herefordshire and Worcestershire can take up to 550 weeks (over 10 years).
For an autism assessment, wait times in Liverpool are 2 years (104 weeks), but Greater Manchester can take over 7 years.
Right to Choose
In England, you can use NHS Right to Choose, which allows you to go to a private clinic with an NHS contract for assessment, at no cost to you.
To be eligible for this pathway, you must be registered with a GP in England. You can’t have already had an assessment with an NHS provider for the same condition, and you can’t self-refer. Your GP needs to agree that referral is the appropriate action as well.
While going through Right to Choose can mean you get assessed faster than on the NHS, there are still wait times to consider.
Private Clinic
Going private for an autism or ADHD assessment is often the fastest route to take, with some clinics being able to see you in just a few weeks. Plus, you can choose the clinic you go to or even explore online assessment options.
Keep in mind that private clinics do charge for assessments, so make sure to discuss payment options before booking.
Book a Private ADHD or Autism Assessment with Neuroaffinity
Here at Neuroaffinity, we provide expert ADHD and autism assessments to ensure you get the answers you need without the wait.
We can see you in as little as 4 weeks, helping you beat the lengthy waiting lists elsewhere. With both in-person and online assessments available, you can choose a pathway that works for your schedule. Get in touch with us today to discuss your options.
You can reach us via phone on 0776 856 5162 or email us at enquiries@neuroaffinity.co.uk. Alternatively, fill out our contact form, and we’ll call you back.
Is your insurance with AXA or Bupa? Discover whether AXA covers ADHD and autism assessments and if you can get an ADHD or autism assessment with Bupa on our blog.
