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New Jersey 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 New Jersey has a specific autism mandate.

The mandate requires specified health insurance policies and health benefit plans to provide benefits for treatment of autism or other developmental disability. Coverage shall include: medically necessary occupational therapy, physical therapy, and speech therapy, as prescribed through a treatment plan. The maximum benefit amount for a covered person in any calendar year through 2012 shall be $37,080.

Resources

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

N.J. Rev. Stat. § 17:48-6ii; § 17:48A-7ff; 17B:26-2.1cc; 17B:27-46.1ii; 17B:27A-7.16; 17B:27A-19.20; § 26-2J-4.34; § 52:14-17.29p; 52:14-17.46.6b

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

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