Introduction

This site is designed to help parents and families of children with Autism Spectrum Disorders find insurance resources for the treatment of ASDs. This website is a wiki – it is designed for everyone to contribute their knowledge related to insurance coverage of Autism. The main focus of the site is related to insurance coverage for Applied Behavioral Analysis (ABA) or similar intensive one-on-one therapy. Please consider contributing yourself to the community knowledge on this site by clicking “Edit this Page” icon at the bottom from any page; or, if you prefer, you can e-mail your personal knowledge to the volunteer team who will add it to the site.

See also What is a wiki

See also Overview of Insurance Options for Autism Coverage

Space reserved to introduce different insurance options and help explain the differences between ST, OT, ABA, etc. In addition, space reserved to introduce State Mandates and Self-Funded Company Insurance Plans (ERISA Plans) that offer insurance coverage for ABA or similar.

See also Self-Funded Companies with an Autism Benefit.

Companies may offer behavioral and mental health plans that include a provision for intensive 1:1 therapy for Autism Spectrum Disorders. These are often called “Autism Benefits” or “Enhanced Autism Benefits”, and typically companies must specifically opt-in for this additional coverage.

Companies that offer behavioral and mental health plans but do not offer an autism benefit are subject to State Mandates for Autism Coverage if they are fully insured plans. A fully insured plan means that a company purchases insurance to cover health benefits instead of paying for these benefits directly themselves (a “fully-funded plan” or “self-funded plan”).

We are actively looking for community information and volunteers to help build out the knowledge-base on which companies offer an Autism benefit and details about that benefit. Please visit the Self-Funded Companies with an Autism Benefit page for more details or to contribute.

See also State Mandates for Autism Coverage.

Currently, 35 states enacted laws related to Autism Spectrum Disorders and insurance coverage, of which 23 states specifically require insurers to provide coverage for treatment. In addition, there is a federal bill in committee (S.819 and H.R.2413 that may mandate insurance coverage for Autism Spectrum Disorder treatment.

Search for information on a specific state's coverage.