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Autism Insurance Reform

by Pat on Dec 14, 2008 at 1:32 PM Filed in Autism Legislation, Autism and Insurance

Families with children on the autism spectrum face a considerable financial burden.  This is due, in part, to the numerous therapies and medications that are necessary to treat the emotional, developmental, and behavioral aspects of autism.  Many autistic children need speech therapy, occupational therapy, physical therapy, and behavioral therapy. Additionally, they may take 2 or more medications to control their behavior and stabilize their moods. Therapies and medication are just part of the expense. In some families, one parent must reduce or stop working in order to care for the child and take him or her to the therapy apppointments.

Many insurance companies routinely deny claims for treatment for autism spectrum disorders by either limiting the amount of therapy provided under mental health coverage or by taking the position that the treatment is "educational" in nature, and not medical, even when it is prescribed by a physician. Other insurers refuse to cover autism spectrum disorders at all by claiming that autism is just a developmental diagnosis. Private therapy can cost anywhere from $75 to $250 an hour or more. Many families are left to depend upon public schools to meet the therapy needs of their child, which places a big burden on the public school system and limits the amount of therapy their child can receive.

Many states have passed insurance reform laws to require insurers to pay for treatment for autism. Currently, all but 15 states have either passed such legislation or are currently working on a bill. The insurance industry itself estimates that adding coverage for autism would only raise premiums less than 1 percent. In some states, like Indiana, that have had a law in effect for several years, the insurance industry has been asked to provide data on this subject, but has not done so. 

It is wrong for insurance companies to deny claims for autism spectrum disorders.  It is wrong to let insurance companies get away with denying claims for autism spectrum disorders. Let your voices be heard.  Contact your state representatives, state senators, and governors. This issue is not going away. It is either going to be a "pay now" situation to help the child when he or she is young, or a "pay later" situation.

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Comments

12/16/2008 2:40:00 PM

Well said, Pat. Thank you for speaking out on this subject!

-Di

Dianna

12/18/2008 8:52:53 PM

Hi Pat,
I saw you on Nancy Grace this evening and the story of other autistic children. ANd I have to share with you something I just learned not long ago. Autism symptoms are in many cases mistaken for the symptoms of food allergies and/or celiac disease. I don't know if you or other mothers are aware of this, but I think it is well worth the time to check into it. I learned this from a man named Dr. RIchard Becker who practices alternative medicine alonog with traditional medicine. I hope you will look into this and that it will help some parents out there who might have autistic children who really aren't autistic. Thank you

Jackie

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