California Insurance Requirements for Autism Spectrum Disorder

The information below is collected from state statutes and regulations. The information is reviewed on an annual basis. Please be advised that laws, regulations, and policies may change at any time, so always check with your state for the most up-to-date information.

Note: Certain insurance plans are exempt from state mandates. Please contact your plan administrator to see if your plan includes state mandated autism spectrum disorder benefits.

Specific Insurance Mandate

The state of California has a specific autism mandate, which requires certain insurers to provide coverage for autism spectrum disorder.

The mandate requires all health care service plan contract that provides hospital, medical, or surgical coverage to provide coverage for behavioral health treatment for pervasive developmental disorder or autism no later than July 1, 2012. Treatments include: professional services and treatment programs, including applied behavior analysis and evidence-based behavior intervention programs, that develop or restore, to the maximum extent practicable, the functioning of an individual with pervasive developmental disorder or autism and includes speech-language pathology and audiology.