For the past few years, several states have transitioned to requiring their state health insurance plans to offer at least some coverage for individuals and families with a need for autism spectrum disorder (ASD) services.
Thanks to improved ASD research and diagnostic methods, specialists can diagnose ASD more precisely than ever before, bringing its diagnosis rate to 1 in 54 children. With diagnoses on the rise, it’s more crucial than ever for individuals and families to get the support they need through covered ASD treatments and services. Your employees may rely on their coverage through your company health insurance plan to include these services.
Although autism isn’t curable and many wouldn't change it if they could, treatments help many people with autism. Through behavioral, occupational, speech, and other therapies, people with autism may improve their communication, fine and gross motor, and self-care skills that affect their everyday tasks. Autism treatments may also aid accompanying conditions, like feeding issues, sleep disturbances, and anxiety.
For some, ASD treatments are necessary to build upon functional skills they’ll use every day. Early intervention for autism spectrum disorder has proven to help children function at school and home. Older children and adults with autism may also benefit from music therapies, mindfulness therapies, and others.
Based on the research we have today surrounding effective autism treatments, it makes sense that health insurance plans cover autism. As of August 1, 2019, all 50 states require at least some health insurance plans to include autism treatments.
Each state has its own laws governing the required amount of coverage regarding ASD treatment. In many states, the bare minimum requirement is for insurance companies to provide coverage for screening, diagnosing, and treating ASD. Some states even mandate that health insurance companies also offer the same coverage for any other condition listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM).
Here are a few examples of ASD health plan coverage laws from specific states:
Not all health insurance plans are subject to state laws. While a state-regulated healthcare plan is required to provide at least the minimum coverage for ASD services, a federally-regulated healthcare plan is not. Furthermore, your self-funded healthcare plan for employees does not need to provide services for ASD because your business funds the custom plan, but fully-insured plans need to submit to regulations.
Still, with the rising prevalence of ASD diagnoses, your employees must get the coverage they need to support themselves or their family members with ASD. Through a self-funded healthcare plan, your company can tailor the plan and its coverages to meet your workers' and their families' needs. The number of businesses electing to cover ASD services, like diagnostics, speech therapy, and applied behavior analysis (ABA), continues to grow, paving the way for your company to follow an upward trend of support and inclusivity.