Insurance Coverage

Brief History of Autism Insurance Mandates

For years, insurance companies and their lobbyists argued convincingly that autism is a developmental disability that needs to be addressed through the Department of Education rather than through health services, especially insured health services.
In 2001, the Indiana state legislature, broke the growing impasse and mandated that private insurers needed to offer their customers autism coverage. Now, 29 more states have jumped in and mandated some kind of insurance coverage for children with autism, moving financial responsibility from school districts and Regional Centers to insurance pools.
The federal government’s Office of Personnel Management tipped the scales even farther, declaring that Autism services should be regarded as an insurable health benefit.

In-network Providers

  • Aetna
  • Cigna
  • Tricare/Optum
  • UBH
  • Blue Shield
  • Anthem/Blue Cross
  • Magellan
  • Humana/Life Sync
  • HealthNet
  • MHN
  • Care1st

How does it work?

Every insurance plan is different, and so are the costs. The cost of insurance is not just on the front end when you pay your premium, but also on the back end through co-payments and deductibles.

Some plans will authorize treatment, but require the family to pay out of pocket and seek reimbursement from the insurance company after the fact. Reports and documentation of services are distributed on an individualized basis to meet the insurance company’s reimbursement schedule.
Private pay is also a good choice when parents feel their child requires greater services than those authorized by their insurance plan.

As you embark on the journey through insurance-funded services, be sure to review all of your anticipated costs and develop a budget.Our insurance specialistwould be happy to help you determine what services you qualify for under your insurance plan.
Below is a copy of our insurance information form, that you can fill out and submit if you like to start the process to enroll your child.

INSURANCE INFORMATION FORM

Client Name:

Clients DOB:

Clients Address:

Subscribers Name (if other than client):

Subscribers Address (if other than client):

Subscribers DOB (if other than client):

Insurance Provider/Managed Care Provider:

Group Number:

Member ID number:

Phone-number Provider Services (on the back of the card):

Scan or picture of the insurance card FRONT & BACK:

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