Massachusetts State-Regulated Insurance Coverage

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

Massachusetts autism insurance bill, H4935, was enacted in 2010 and became effective on January 1, 2011.

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

  • 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)
  • Pharmacy Care
  • Psychiatric Care
  • Psychological Care
  • Speech, occupational and physical therapy

Does Massachusetts have caps on ABA coverage?

No. There are no age or dollar limits on coverage.

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

A copy of H4935 as enrolled can be found here.

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

 

Last Updated: December 2019

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