Hawaii State-Regulated Insurance Coverage

Hawaii requires meaningful coverage for autism under state-regulated plans.

Hawaii’s autism insurance bill, SB 791, was enacted in 2015. The law became effective on July 1, 2015.

To which state-regulated plans does the law apply?

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

What services are covered by law?

  • Applied behavior analysis
  • Pharmacy care
  • Psychiatric care
  • Psychological care
  • Speech, occupational and physical therapy

Does Hawaii have caps on ABA coverage?

Yes. Coverage is limited to individuals under the age of 14 years. ABA coverage is limited to $25,000 per year from birth until age 14. Hawaii Medical Service Association and Kaiser are not enforcing caps on coverage.

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 Illinois autism insurance law?

A copy of SB 791 as enrolled can be found here.

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

 

Last Updated: December 2019

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