If your child has been diagnosed with Attention Deficit/Hyperactivity Disorder (ADHD), you likely face a bumpy road of treatment options and results. Add to that the ups and downs of health insurance.

ADHD is a neurobehavioral condition that can manifest in many ways, including behavorial problems and the inability to pay attention. According to the National Institute of Mental Health, ADHD symptoms become apparent in preschool and the early school years.

According to the Centers for Disease Control and Prevention (CDC), approximately 4.4 million youth ages 4 to 17 have been diagnosed with ADHD by a health care professional, and 2.5 million of those are currently receiving medication treatment for the disorder (as of 2003, the latest data available). In 2003, 7.8 percent of school-aged children were reported by a parent to have an ADHD diagnosis.

ADHD treatment falls under "mental health treatment" benefits, so if your health plan doesn't include mental health coverage, you don't have a claim. Your plan may even specifically exclude coverage of ADHD, so read it carefully before pursuing a claim. Even if you have a health plan, be it group or individual, that appears to have generous mental health coverage, you may find yourself with out-of-pocket co-insurance payments or deductibles, or maxing out your allowable outpatient visits for the year.

You may even find your ADHD treatment claim denied if it's deemed not "medically necessary."

If you have belong to an HMO, your choices of providers and benefits could be restricted and you may need to run a gauntlet of pre-authorization requests; without the right pre-authorization before treatment, you claim could be denied. For more, read Getting mental health treatment coverage for children.

Most states have enacted mental health parity laws, and some states name ADHD treatment in those. These laws require insurers to cover mental health treatment at equal levels to physical illness coverage. According to the National Alliance on Mental Illness, these states have mental health parity laws that specifically include ADHD coverage: Delaware, Kansas, Virginia and West Virginia.

For a full list, see Mental health parity laws by state.

Further compounding the health insurance situation of parents of children with ADHD is that it often coexists with other psychiatric conditions, sometimes with overlapping symptoms. The National Resource Center on AD/HD identifies these as the most common coexisting conditions:

• 1. Disruptive behavior disorders
• 2. Mood disorders
• 3. Anxiety disorders
• 4. Tics and Tourette Syndrome
• 5. Learning disabilities

Like ADHD, these would need to be diagnosed by a mental health professional. But also like ADHD, coverage varies greatly by insurer and even among policies from the same insurer.

According to America's Health Insurance Plans (AHIP), an industry trade group, "Medical evidence drives coverage decisions. If a treatment is proven to work, it is generally covered by health plans. We need a national comparative effectiveness entity that compares new and existing drugs, technologies, and treatments to determine what works and what works best. We also need a system to put that information in the hands of consumers and physicians."

In addition, parents of children with ADHD may hear about alternative treatments for the condition, which would be used in lieu of prescription drugs or a medical doctor's treatment. There may also be complementary treatments available, which would be used in conjunction with standard medical treatment. The National Resource Center on AD/HD urges caution before embarking on alternative or complementary treatments that haven't been tested and reviewed by medical experts. Examples of alternative and complementary treatments for ADHD that have not been proven by scientific research, according to the Resource Center, include dietary treatments such as removing foods from the diet, EEG biofeedback, chiropractic care and vision therapy.

If you decide to go this route, you'll do it at your own cost: Health insurance won't cover investigational or unproven treatments.

The National Resource Center on AD/HD at www.Help4ADHD.org acts as a clearinghouse of science-based information about the condition.

If you do receive an ADHD-treatment referral from your health insurer, it will likely be from a company contracted by your health insurer specifically to provide mental health treatment. Magellan Health Services and ValueOptions, for example, are large contractors for mental health treatment and other services.

And if your child has been diagnosed, take advantage of all the resources available from your health insurer. According to AHIP, "Health plans have implemented a number of tools to assist individuals with behavioral health conditions, including medical management, health coaching, employee-assistance programs, and a variety of Web-based support tools."