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.
The state of Indiana has a specific autism mandate, which requires certain insurers to provide coverage for autism spectrum disorder.
The mandate requires group and individual policies to provide coverage for the treatment of a pervasive developmental disorder of an insured. A pervasive developmental disorder is defined as a neurological condition, including Asperger's syndrome and autism, as defined in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association. The coverage required may not be subject to dollar limits, deductibles, or coinsurance provisions that are less favorable to an insured than the dollar limits, deductibles, or coinsurance provisions that apply to physical illness generally under the accident and sickness insurance policy.
Note: Speech language services are not specifically defined in the statute. Coverage is "limited to treatment that is prescribed by the insured's treating physician in accordance with a treatment plan."
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.