Kentucky State-Regulated Insurance Coverage

Kentucky requires meaningful coverage for autism under state regulated plans.

Kentucky’s autism insurance bill, HB 159 was enacted in 2010 and became effective January 1, 2011. This law was amended to remove caps on coverage.

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

  • State Employee Health Plans - YES
  • Individual Plans - YES
  • Fully Insured Large Group Plans - YES
  • Fully Insured Small Group Plans - YES

What services are covered by law?

  • Diagnosis
  • Habilitative or rehabilitative care (e.g. Applied Behavior Analysis)
  • Medical Care
  • Pharmacy Care
  • Psychiatric Care
  • Psychological Care
  • Therapeutic care (e.g. Speech, occupational and physical therapy)

Does Kentucky have caps on ABA coverage?

No, the original legislation was amended to remove all caps.

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 Kentucky autism insurance law?

 A copy of HB159 as enrolled can be found here.

 A copy of HB218 which removed dollar and age caps can be found here.

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

 

Last Updated: December 2019

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