Minnesota State-Regulated Insurance Coverage

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

Minnesota’s autism insurance bill, HF 1233, was enacted in 2013. The law became effective for fully insured large group plans on January 1, 2014.

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?

  • Diagnosis, evaluation, and multidisciplinary assessment
  • Early intensive intervention (e.g., autism treatment options based in behavioral and developmental science, which may include modalities such as applied behavior analysis, developmental treatment approaches, and naturalistic and parent training models.)
  • Neurodevelopmental and behavioral health treatment
  • Occupational therapy
  • Physical therapy
  • Medications

Does Minnesota have caps on ABA coverage?

Yes. The law limits coverage to individuals with autism less than 18 years of age. There are no annual or lifetime dollar caps on benefits.

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

A copy of HF 1233 (Article 12) as enrolled can be found here.

Other comments about the law.

In addition to the private insurance provisions, HF 1233 also addressed coverage for autism through Medicaid and benefits available through the Minnesota Comprehensive Health Association (MCHA) high risk pool.

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.

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

 

Last Updated: December 2019

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