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Texas 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 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.

Resources

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.

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