Many Health Plans Now Must Cover Autism Symptoms Diagnosis
Do you think your child has autism symptoms? Not sure? Much of the following information is gleaned from the New York State Insurance Department with additional comments added by Craig Kendall.
Early Screening for Autism Symptoms is Key
Early diagnosis is critical in treating children with autism spectrum disorders (ASD), so new parents should know that new federal health reforms require many insurance plans to cover autism spectrum and developmental screenings for infants. (So if your child exhibits ANY autism symptoms, it is a good idea to get him or her tested).
“Health experts estimate that as many as one of every 110 children have a diagnosis of ASD, so it is essential that new parents understand exactly what the law requires so that an early diagnosis is possible,” Insurance Superintendent James Wrynn said.
ASD is defined as a neurobiological condition that includes autism, Asperger Syndrome, Rett’s Syndrome or pervasive development disorders. It’s estimated more than 60,000 New Yorkers have ASD.
“Under the new Affordable Care Act, autism screening for children at 18 and 24 months must be covered without having to pay out-of-pocket expenses when these services are delivered by a network provider. The new federal reforms also require well-baby and well-child visits with physician’s visits every few months when a child is young,” Wrynn said.
These new rules mean parents who suspect their children of showing autism symptoms cannot be charged a co-pay, co-insurance or have to meet a deductible to receive these services for autism symptom testing. The rules affect consumers who have new health plans or insurance policies which began on or after Sept. 23, 2010.
New Federal Reforms help Pay for Testing of Autism Symptoms
Parents should also be aware that under the new federal reforms:
- Health plans are now prohibited from excluding coverage of pre-existing conditions for children ages 18 or younger (which includes autism and testing of autism symptoms).
- Lifetime dollar limits on essential health benefits have been prohibited for health plans issued or renewed on or after Sept. 23, 2010, and annual dollar limits will be gradually phased out. This is important giving that autism treatment can be very expensive for parents which autistic kids. Just testing for autism symptoms can also expensive.
The new federal law supplements existing New York laws which directly impact health insurance coverage for ASD (autism spectrum disorder) diagnosis and treatment (and the testing and screening of autism symptoms).
New York’s Autism Statute prohibits a health maintenance organization (HMO) or insurer from excluding coverage for the diagnosis and treatment of medical conditions (such as testing for autism symptoms and treating autism) otherwise covered by a policy.
Timothy's Law Requires Coverage for Autism Symptom Testing and Treatment
A second law, known as Timothy’s Law, requires group health insurance policies and contracts to provide coverage for the diagnosis and treatment of mental health conditions, including ASD (autism, Asperger's syndrome, Rett disorder), when care is provided in a hospital, a facility issued an operating certificate by the Commissioner of Mental Health, a facility operated by the Office of Mental Health, or when care is provided by a psychiatrist, psychologist or licensed clinical social worker. (Of course this would include testing for autism symptoms as well).
For additional information about ASD, and if you suspect your child exhibits autism symptoms read these articles: Top Ten List – Signs Your Child Has Autism and How to Know if Your Child Has Autism.
Parents need to understand the issues that afffect their children which autism.
Early autism diagnosis and treatment (and early screening for autism symptoms) can make life a little easier especially for those with autism and the people who love them. And for additional tips and suggestions that can help your children with autism live a fulfilling and happy life read Craig Kendall's book, The Autism Survival Guide.
Craig's book The Autism Survival Guide has received rave reviews from parents and professionals alike for its pragmatic and practical approaches to solving the everyday problems that parents face.
Click here for more information on screening for autism symptoms in Craig's book.
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