Home HealthTopics Health Centers Reference Library Research
Join us on Facebook Join us on Facebook Share on Facebook

Autism

What is the Availability of Autism Insurance?

11/25/2008

Question:

I am a mother of three young children and my oldest has autism (6-years-old). We are thinking of moving to the states but I was wondering what states have an insurance plan that insures autism therapy? And how much of it is covered? Do you have to pay for Medicare to get these services, if so how much?

Answer:

Several states have enacted legislation requiring private insurance companies to include coverage of autism spectrum needs, including Pennsylvania, Hawaii, South Carolina, Arizona, Louisiana, and a few others. Florida has coverage with some limitations. Coverage is under consideration in Ohio.

It would be important to check Internet resources for the states you may be considering because some have exclusions for employers of fewer than 50 individuals, for example. If you search the websites of the Autism Society of America and Autism Speaks, you can get more detailed information.

The Autism Society of America has prepared state profiles in a systematic format that describe what action has been taken or is under consideration on a state-by-state basis. www.autism-society.org/ (Search "autism insurance coverage") In addition, "... some self-insured companies, including Microsoft and Home Depot, pay for autism behavior therapy."

www.autismspeaks.org/inthenews/autism_insurance_ap.php

Federal laws can make additional requirements. President-elect Obama has publicly stated support for national legislation that would require autism coverage in all states, so more changes may take place in the next few years: In his presidential campaign statement on Autism Spectrum Disorders, President-elect Obama committed to bringing autism insurance reform to the entire nation. It stated that Obama and Biden "will mandate insurance coverage of autism treatment and will also continue to work with parents, physicians, providers, researchers, and schools to create opportunities and effective solutions for people with ASD."

For the complete campaign statement, and to read the draft legislation, go to http://www.autismvotes.org/, and sign up to receive action alerts pertaining to this important initiative. www.autismspeaks.org/inthenews/obama_insurance_mandate_bill.php

Medicare is not usually involved in this situation unless a parent is deceased or if a parent has reached retirement age and the child previously received benefits under Medicaid, a federal program for the poor and/or disabled that may offer some medical coverage for children with disabilities under certain circumstances.

For more information:

Go to the Autism health topic, where you can:

Response by:

Patricia H Cloppert, BSFS Patricia H Cloppert, BSFS
Faculty Parent Advocate
Program Manager for Parent/Family Support
OSU Nisonger Center
The Ohio State University