Louisiana State-Regulated Insurance Coverage

Louisiana requires meaningful coverage for autism under state regulated plans.

Louisiana’s autism insurance bill, Act 648, was enacted in 2008 and became effective on January 1, 2009. The law was amended by Act 208 in 2012 and became effective on January 1, 2014.

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

  • State Employee Health Plans - YES
  • Individual Grandfathered Plans - NO
  • Individual Non-Grandfathered 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 (Applied Behavior Analysis)
  • Pharmacy Care
  • Psychiatric Care
  • Psychological Care
  • Therapeutic care (Speech, occupational and physical therapy)

Does Louisiana have caps on ABA coverage?

Yes. The law limits coverage to individuals with autism under the age of 21. Coverage for the treatment of autism is subject to a maximum annual benefit of $36,000.

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.  Learn more here.

Where can I find more details about the Louisiana autism insurance law?

A copy of Act 648 (2008) as enrolled can be found here. A copy of Act 208 (2012) as enrolled can be found here.

Other comments about the law.

The 2012 Louisiana autism insurance law raised the age cap from 17 to 21 years, eliminated the lifetime maximum benefit, and extended coverage to small group plans effective January 1, 2014.

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

 

Last Updated: December 2019

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