Arizona State-Regulated Insurance Coverage

Arizona requires meaningful coverage for autism under state-regulated plans. Arizona’s autism insurance bill, HB 2847, was enacted on March 21, 2008. The law became effective on June 30, 2009.

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

  • State Employee Health Plans - YES
  • Individual Grandfathered Plans - NO
  • Individual Non-Grandfathered Plans - YES
  • Fully Insured Large Group Plans - YES
  • Fully Insured Small Group Grandfathered - NO
  • Fully Insured Small Group Non-Grandfathered Plans - YES

What services are covered by the law?

  • Diagnosis
  • Behavioral Therapy Services

Does Arizona have caps on ABA coverage?

Yes. Coverage for behavioral therapy (ABA) is limited to individuals with autism that are less than 17 years of age and is subject to the following annual dollar caps:

  • Under the age of 9= $50,000/year
  • Between the ages of 9 and 16 = $25,000/year

The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) is a federal law that generally prevents group health plans and health insurance issuers that provide mental health or substance use disorder (MH/SUD) benefits from imposing less favorable benefit limitations on those benefits than on medical/surgical benefits.  This includes quantitative treatment limits like age and dollar caps. Learn more here.

Where can I find more details about the Arizona autism insurance law?

 A copy of HB 2847 as enrolled can be found here.

Other comments about the law.

For purposes of this law, “behavioral therapy” is defined as “interactive therapies derived from evidence based research, including applied behavior analysis, which includes discrete trial training, pivotal response training, intensive intervention programs and early intensive behavioral intervention.”

If you have additional questions, please email advocacy@autismspeaks.org.

 

Last Updated: December 2019

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