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Massachusetts 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 Massachusetts has a specific autism mandate, which requires certain insurers to provide coverage for autism spectrum disorder.

Effective January 1, 2011, requires insurance coverage for autism. Treatment includes the following care prescribed, provided or ordered for an individual diagnosed with 1 of the autism spectrum disorders by a licensed physician or a licensed psychologist who determines the care to be medically necessary: habilitative or rehabilitative care; pharmacy care; psychiatric care; psychological care; and therapeutic care, including speech therapy services. Certain insurers may be exempt from requirements for 3 years.

Resources

For further information on insurance mandates for autism spectrum disorder, please visit these websites: 

Questions regarding state affairs issues? Call ASHA at 800-498-2071 and ask for the State Affairs Team.

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