Texas Insurance Requirements for Autism
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 Texas has a specific autism mandate.
The mandate requires a health benefit plan to provide coverage to an enrollee who is diagnosed with autism spectrum disorder from the date of diagnosis until the enrollee completes nine years of age. If an enrollee who is being treated for autism spectrum disorder becomes 10 years of age or older and
continues to need treatment, this does not preclude coverage of treatment and services. Treatment may include services such as: evaluation and assessment services; applied behavior analysis; behavior training and behavior management; speech therapy; occupational therapy; physical therapy; or medications or
nutritional supplements used to address symptoms of autism spectrum disorder.
For further information on insurance mandates for autism spectrum disorder, please visit this website:
Tex. Ins. Code Ann. §1355.015
Questions regarding state affairs
issues? Call ASHA at 800-498-2071 and ask for the State Affairs Team.