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. The state autism insurance law was also updated in 2020.
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, evaluation, and multidisciplinary assessment
- Early intensive behavioral and developmental therapy based in behavioral and developmental science, including but not limited to applied behavior analysis, intensive early intervention behavior therapy and intensive behavior intervention
- Neurodevelopmental and behavioral health treatment and management
- Speech therapy
- Occupational therapy
- Physical therapy
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.
However, federal mental health parity law disallows capping treatment at age 18.
Where can I find more details about the Minnesota autism insurance law?
Click here for a copy of HF 1233 (Article 12) as enrolled.
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.
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Last Updated: June 2022