New Hampshire State-Regulated Insurance Coverage

New Hampshire requires meaningful coverage for autism under state regulated plans.

New Hampshire’s autism insurance bill, HB 569, was enacted in 2010 and became effective on January 1, 2011. 

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 - YES

What services are covered by law?

  • Applied Behavior Analysis
  • Pharmaceuticals
  • Direct or consultative services provided by a licensed professional including a licensed psychiatrist, licensed advanced practice registered nurse, licensed psychologist or licensed clinical social worker
  • Speech, occupational and physical therapy

Does New Hampshire have caps on ABA coverage?

Yes. Coverage for ABA is limited to individuals ages 0 to 21 years and is subject to annual dollar caps. For individuals 0 to 12 years of age, coverage is capped at $36,000 per year. For individuals 12 to 21 years of age, coverage is capped at $27,000 per year. 

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 New Hampshire autism insurance law?

A copy of HB 569 as enrolled can be found here.

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

 

Last Updated: December 2019

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