Florida State-Regulated Insurance Coverage
Florida requires meaningful coverage for autism under state-regulated plans.
Florida’s autism insurance bill, SB 2654, was enacted in 2008. The law became effective on April 1, 2009.
To which plan types does the STATE autism insurance law apply?
- State Employee Health Plans- YES
- Individual Plans- NO
- Fully Insured Large Group Plans- YES
- Fully Insured Small Group Plans- NO
What services are covered by law?
- Screening and diagnosis
- Applied Behavior Analysis
- Speech, occupational and physical therapy
Does Florida have caps on ABA coverage?
Yes. Individuals must have been diagnosed with a developmental disability at 8 years of age or younger to be eligible. Coverage is extended to those older that 18 as long as they are in high school. Coverage for the treatment of autism is subject to a maximum annual benefit of $36,000 and a lifetime limit of $200,000.
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.
Where can I find more details about the Florida autism insurance law?
Click here for a copy of Senate Bill 2654 as enrolled.
If you have additional questions, please email email@example.com.
Last Updated: December 2019