Indiana State-Regulated Insurance Coverage

Indiana requires meaningful coverage for autism under state regulated plans.

Indiana’s autism insurance bill, IC-27-8-14.2, was enacted in 2001. The law became effective on July 1, 2001.

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

  • State Employee Health Plans - YES
  • Individual Grandfathered Plans - Only an offer of coverage is required
  • Individual Non-Grandfathered Plans - YES
  • Fully Insured Large Group Plans - YES
  • Fully Insured Small Group Grandfathered Plans - YES
  • Fully Insured Small Group Non-Grandfathered Plans - YES

What services are covered by law?

Treatment that is prescribed by the insured’s treating physician in accordance with a treatment plan.

Does Indiana have caps on ABA coverage?

No. There are no limits 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 Indiana autism insurance law?

A copy of IC-27-8-14.2 as enrolled can be found here. For additional details on the Indiana autism insurance law, please visit The Indiana Resource Center for Autism.

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.

Other comments about the law.

The Indiana autism insurance law does not require that insurers provide coverage for the treatment of autism in individual plans, rather it requires that insurers offer such coverage i.e., the law requires a “mandated offering.”

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

 

Last Updated: December 2019

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