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Ins Coverage and ASD?

irishbaby0708irishbaby0708 member
in Special Needs
Are things covered differently on your insurance once you have ASD dx?  Just curious.
10/17/2009 - Our Miracle came 10 weeks early. IF,2 MC and 1 Preemie we have our miracle.. Baby Hope 10 weeks 5days was taken from us on Dec 18, 2007. Forever with us and Forever missed. Triplets Lost baby A @ weeks, Lost Baby B at 6 weeks and lost baby Abigail at 14 weeks when she was born to little for this life..... Forever with us ....
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Re: Ins Coverage and ASD?

  • mommyof4boysmommyof4boys member
    NJ has a law that should cover all developmental delays for children.  I don't remember the specifics but do know our insurance agreed to cover because I cited the law a few years back.
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  • finsupfinsup member

    Totally all over the place and depending on state / insurance.

    Last year during open enrollment I was comparing what my employer offered vs. what my husbands employer offered.

    My employer covered ABA but had a cap at 20 visits per year for OT, PT. 

    My husbands employer also covered ABA but unlimited visits for OT and PT if there is an ASD dx.  If no ASD dx then the standard 20 visit limit for OT and PT applied.

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  • d.fd.f member
    Not with my insurance (through DH's employer),  my state does have a mandate but it excludes self-insurers (which our plan is).  They cover no behavioral therapy unless there is a danger to self or others.  They cover 30 visits of OT and Speech as long as it's recommended by a doctor.   ASD plays no role regarding inclusions or exclusions.

    DS 09/2008

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  • KelleyBeanKelleyBean member
    We are in the process of moving from my insurance to DH's. My state is a mandate state but my company is considered self-insured so they offer no therapy benefits. DH's plan gives $35k a year in ABA with an ASD dx. There is also ST, PT and OT but I'm not sure on limits. I do know it is better than the non-coverage of my employer so it was a no-brainer for us. 
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  • CaptainSeriousCaptainSerious member
    On ours, yes, but I don't know all the specifics.
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