Alaska state-regulated insurance coverage

Alaska requires meaningful coverage for autism in its state-regulated health insurance plans.

Alaska’s autism insurance bill, SB 74 was enacted in 2012. The law became effective January 1, 2013.

To which plan types does the STATE autism insurance law apply?

  • Individual Plans - YES
  • Fully Insured Large Group Plans - YES
  • Fully Insured Small Group Plans - YES

What services are covered by the law?

  • Diagnosis
  • Pharmacy Care
  • Psychiatric Care
  • Psychological Care
  • Applied Behavior Analysis and other structured behavioral therapies
  • Speech Therapy, Occupational Therapy, Physical Therapy

Does the law impose age limits or annual dollar caps on coverage?

Coverage is limited to individuals with autism under 21 years of age. There are no annual dollar caps on coverage. 

  • Whether or not these caps are included in a health insurance plan is specific to each type of plan, and such limitations are required to be disclosed in the plan document. Most often, there is a specific section of the plan that describes the plan’s autism/ABA benefit. A consumer can contact plan representatives to learn where to find autism-related information in the plan document.
  • There are now laws that challenge the validity of the age and dollar cap limitations. These are known as “mental health parity” laws, and they generally apply to services used to treat autism.
  • Mental health parity laws prevent group health plans [and health insurance issuers] that provide mental health or substance-use disorder (MH/SUD) benefits from imposing less favorable limitations on MH/SUD benefits than on medical/surgical benefits. This means that quantitative treatment limits like age and dollar caps are not permitted in most cases. 
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