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

The mandate requires a group plan established for employees of the state providing for third-party payment or prepayment of health, medical, and surgical coverage benefits shall provide coverage benefits to covered individuals under twenty-one years of age for the diagnostic assessment of autism spectrum disorders and for the treatment of autism spectrum disorders. Treatment includes medically necessary pharmacy care, psychiatric care, psychological care, rehabilitative care, and therapeutic care (including services provided by a licensed speech pathologist, licensed occupational therapist, or licensed physical therapist). Coverage shall not exceed thirty-six thousand dollars per year but shall not be subject to any limits on the number of visits to an autism service provider for treatment of autism spectrum disorders.

Resources

For further information on insurance mandates for autism spectrum disorder, please visit this website: 

Iowa Code §514C.28

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

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