Does insurance cover psychoeducational assessments?

Private Psychoeducational Assessments

The short answer is YES - many do cover the assessment, but it totally depends on your company policy. It never hurts, however, to investigate the possibility.

As many of us are aware, private psychoeducational assessments can be very expensive, usually costing around $3,000, so many opt to wait for schools to do one which can take years to complete due to long wait lists. More importantly, the longer the school has you wait, the longer your child waits for helpful accommodations and modifications that could lighten their daily school struggles.

Here is the checklist I recommend to clients:

1. Check your extended healthcare insurance with your employer. It might be listed under medical, paramedical or mental health services. When in doubt, (or short on time!) call the insurance company and ask about psychology coverage and the amount that is covered.  Since each family member will have coverage, the assessment cost can often be legitimately split over the child and each parent/guardian as there is full and complete family involvement in this process.

2. Once coverage is confirmed, there are many psychologists who can perform these assessments. JVS has sliding scale assessments and Facebook groups can be great places for referrals as well as searching ‘psychoeducational assessments, city’. Call and see how flexible their billing is -some will split the billing between years as long as half is done at the end of one year; the second half done in January of the following (leveraging two years of benefits).

3. Here is quick list of the pros and cons of private versus school assessments:

PRIVATE ASSESSMENTS:

PROS:
-Usually, there is a far shorter waiting time to get started
-In most cases, the timeline for assessments will be shorter i.e. the final report quicker
-You choose the evaluator
-You do not need the school’s involvement and do not need to share the results
-Testing can be focused
-Your child will get undivided attention

CONS:
-Testing can be expensive
-Your child will be in an unfamiliar environment with a new person
-You will need to request  school records to share with the evaluatro

SCHOOL  ASSESSMENTS:

PROS:
-Multiple professionals MAY work together on the assessment
-Testing is FREE
-Familiar environment for testing

CONS:
-You do NOT choose the evaluator
-Most families wait 1-3 years on for assessments

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