Nebraska State-Regulated Insurance Coverage

Nebraska requires meaningful coverage for autism under state regulated plans.

Nebraska’s autism insurance bill, LB 254, was enacted in 2014 and became effective on January 1, 2015.

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

  • Individual Grandfathered Plans - YES
  • Individual Non-Grandfathered Plans - NO
  • Fully Insured Large Group Plans - YES
  • Fully Insured Small Group Grandfathered Plans - YES
  • Fully Insured Small Group Non-Grandfathered Plans - NO

What services are covered by law?

  • Diagnosis
  • Pharmacy Care
  • Psychiatric Care
  • Psychological Care
  • Behavioral health treatments, including Applied Behavior Analysis (ABA)
  • Therapeutic Care (Speech, occupational and physical therapy)

Does Nebraska have caps on ABA coverage?

Yes. Coverage is limited to individuals with autism less than age 21. Behavioral health therapies, including ABA, are limited to 25 hours per week.

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 Nebraska autism insurance law?

A copy of LB 254 as enrolled can be found here.

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

 

Last Updated: December 2019

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