Nevada State-Regulated Insurance Coverage
Nevada requires meaningful coverage for autism spectrum disorder under state regulated plans. Nevada’s autism insurance bill, AB 162, was enacted in 2009. The law became effective on January 1, 2011.
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 - YES
What services are covered by law?
- Screening and diagnosis
- Habilitative or rehabilitative (including applied behavior analysis)
- Prescription Care
- Psychiatric and Psychological Care
- Speech, occupational and physical therapy
Does Nevada have caps on ABA coverage?
Yes. The law limits to individuals with autism under the age of 18 (or until age 22 if still enrolled in high school.) Coverage for ABA 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 Nevada autism insurance law?
A copy of AB 162 as enrolled can be found here.
Other comments about the law.
The Nevada autism insurance law does not require that insurers provide coverage for the treatment of autism in individual plans, rather it requires that insurers offer such coverage i.e., the law requires a “mandated offering.”
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Last Updated: December 2019