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Autism Speaks Insurance Link

Want to find out if you are entitled to autism benefits under your current health insurance plan?  Visit our web-based interactive tool kit to find answers. Log in here.

 

Health Insurance Marketplaces and Autism

Autism Speaks has produced resources to help families better understand how the Affordable Care Act ("Obamacare") impacts their insurance coverage. The resources include fact sheets, basic information about the law and helpful links. Learn more here.

 

Self-Funded Employer Tool Kit (ERISA) and Federal Employee Health Benefit Plans

Self-funded insurance plans are one of the most widely used forms of insurance coverage offered by employers. Because such plans are covered under federal law, they are exempt from state autism insurance laws. Autism Speaks has created this tool kit to help families find the coverage they need. 
 
During the recently concluded open season, federal employees and retirees were able to select a 2017 Federal Employees Health Benefits (FEHB) Program health insurance plan that covers applied behavior analysis (ABA) for autism.  All the FEHB plans cover ABA but require prior approval for ABA services. Age restrictions vary, and some plans cap the amount of services or specify who can provide them.  For more information on specific plans, please email us at familyservices@autismspeaks.org or advocacy@autismspeaks.org.  Our analysis is intended only as a guide; FEHB participants should carefully review plan offerings.  Full plan information is available here

Questions? Call us at 888-288-4762 or en Español 888-772-9050, or email familyservices@autismspeaks.org or advocacy@autismspeaks.org.

 

Additional Insurance Policy Resources

Fiscal Impact of Autism Insurance Reform

Autism Speaks analyzed claims data in states that have enacted autism insurance reform laws to determine their actual impact on member premiums. View the data analysis here

FAQs: State Autism Insurance Reform Laws

45 states have required autism insurance coverage by law. Find out what your state requires.

BACB Model Licensure/Regulation Act

The Behavior Analyst Certification Board created this model act for states considering licensure or other form of regulation of individuals certified by the board. 

Cost Studies: State Autism Insurance Reform

Autism Speaks engaged a leading independent actuarial firm, Oliver Wyman Group, to develop a robust cost model and cost estimates for state autism insurance reform bills we endorse.

Applied Behavior Analysis CPT Coding Crosswalk Guide 

A workgroup was formed to collect information about utilization of the Category III Adaptive Behavior Codes for reporting applied behavior analysis (ABA) services in preparation for submitting a Code Change Proposal to the American Medical Association CPT Editorial Panel. The following crosswalk information will foster a greater understanding of how the Category III codes were intended to be reported and encourage uniform reporting of ABA services across providers, payers, and states. See the crosswalk information here.
 
To get involved in autism insurance reform, be sure to follow @AutismVotes on Facebook and Twitter and sign up to recieve updates on our efforts here.