What Insurance Companies (plans) Cover Autism Treatment? - Autism Spectrum Message Board

heatherjudd · 08-24-2005, 07:24 PM

Many that I have heard about deny to cover anything. (Is this just a tactic, or are there only specific insurance companies that cover anything?

ferfyw · 08-24-2005, 09:45 PM

My insurance company-blue shield of Ca hmo -paid for speech therapy for my son. I have been very happy with all of the services they have provided. I think in the state of Ca insurance companies are required to provide services for autistic children. My son is receiving other services -(OT) through the regional center. He is only 22 mos so he still qualifies for EI programs.

Kathy

SHReed · 08-25-2005, 09:52 AM

I would check with your state's Insurance Board to see if there's an Autism mandate for insurance companies. Here in Indiana, if you work for a company that has its headquarters in Indiana, the company's insurance is required to cover autism-related expenses unless the insurance is "self-funded" (i.e. if the company you work for is considered your insurance provider rather than Anthem, Cigna, etc.) My husband works for a company in Indiana, but the company's headquarters are in Florida, so we are covered only if Florida has an insurance mandate for autism. If you aren't covered by a group insurance policy and have private insurance, I believe that the company is required to offer additional coverage for autism.

D & K's Mom · 08-25-2005, 10:19 AM

My Insurance refuses to cover anything. They consiter this a mental health issue, and they don't cover mental health. I spent so long argueing with them that this is a NEUROLOGICAL issue, not mental health, but they won't budge. I have Blue Preffered. (Yeah preffered by who?)

AggieMom · 08-26-2005, 02:57 PM

My husband works for a fortune 500 company and they have had Cigna PPO which is really great insurance, but it is only administered by Cigna. His company makes the decisions as a "self funded" plan. They paid without question for 3 years of OT and ST, but as of January this year they said "Oops we shouldn't have been paying for that and now we won't." I argued and researched all the way to the Stae Board of Insurance and the Employment Commission- no good. During that time I paid an out of pocket rate to my therapists office and tried to hang in there, but it was too much of a drain financially. Funny thing is, the therapy office continued to bill the insurance company and after the first few denials, they started paying again. I know that it's just a matter of time before they figure out that they let me "slip through" the cracks again and then they COULD request the doctors office to refund they money. So I don't feel like pushing my luck and now my son only gets what therapy the school offers. I hate insurance companies!