Iowa State-Regulated Insurance Coverage

Iowa requires meaningful coverage for autism under state regulated plans.

In 2017, HF 215 (beginning at Sec. 4.) was passed which added coverage to large group plans and became effective January 1, 2018.

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

  • Individual Plans - NO
  • Fully Insured Large Group Plans - YES
  • Fully Insured Small Group Plans - NO

What services are covered by law?

  • Applied Behavior Analysis

Does Iowa have caps on ABA coverage?

Yes. The law limits coverage to individuals with autism under the age of 19 years. Coverage for ABA is subject to a maximum annual benefit of $36,000 from ages 0 to 7 years, $25,000 from 7 to 14 years and $12,500 from 14 to 19 years. 

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 Iowa autism insurance laws?

A copy of HF 215 (beginning at Sec. 4.) as enrolled can be found here.

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

 

Last Updated: December 2019

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