Arkansas State-Regulated Insurance Coverage
Arkansas requires meaningful coverage for autism under state-regulated plans.
Arkansas’ autism insurance bill, HB 1315, was enacted in 2011. The law became effective on October 1, 2011.
To which plan does the STATE autism insurance law apply?
- Individual Grandfathered Plans - NO
- Individual Non-Grandfathered Plans - YES
- Fully Insured Large Group Plans - YES
- Fully Insured Small Group Plans - YES
What services are covered by the law?
- Applied Behavior Analysis
- Pharmacy Care
- Psychiatric Care
- Psychological Care
- Therapeutic Care (Speech therapy, occupational therapy and physical therapy)
- Equipment determined necessary to provide evidence-based treatment
- Any medically necessary and evidence-based care (as determined by a licensed physician)
Does Arkansas have caps on ABA coverage?
Yes. Coverage for ABA is limited to individuals with autism under 18 years of age and is subject to a $50,000 annual cap.
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 Arkansas autism insurance law?
A copy of HB 1315 as enrolled can be found here.
If you have additional questions, please email firstname.lastname@example.org.
Last Updated: December 2019