Finding Help With Autism Insurance Coverage

All 50 states have laws that say insurance companies must pay for autism treatment, although what is covered can vary. For those with private insurance coverage, the first step is to find out what your plan is and then look up what kind of coverage for autism each state requires. The National Conference of State Legislatures provides information about autism coverage in each state. In addition:

• Get more information on state regulations for health insurance plans from Autism Speaks.

• Find the local Autism Society to research healthcare options.

Medicaid or Medicare?

Understand the differences between the two in our article on medicare and medicaid for autistic adults. The reason this page doesn’t include links to Medicare coverage for adults with autism is that Medicare does not, at this time, cover the same behavioral health services covered under Medicaid. The best way to get the most up-to-date information about Medicare coverage is to contact them directly at 1-800-MEDICARE.

Find the Health Insurance Marketplace website for each state

The Department of Health and Human services explains how the Affordable Care Act works regarding autism coverage.

Healthcare.gov explains health insurance options and how to qualify for Medicaid or requalify if coverage has lapsed.

Locate the nearest Developmental Disability Council

Every state has a Developmental Disability Council with useful resources on insurance and more. The National Association of Councils on Developmental Disabilities has a directory that leads to the Council in each state.

Find the local Medicaid director

People with Medicaid coverage can use this interactive map with contact information for the Medicaid Director in each state.

Check the U.S. Department of Health & Human Services

The U.S. Department of Health & Human Services Interagency Autism Coordinating Committee (IACC) offers a range of helpful information on state resources for autism, insurance, and health coverage. Some are for children, but many apply to autistic adults, too.

For national and state-specific information see the IACC’s Agencies and Organizations page.

For Massachusetts families – and beyond

The Insurance Resource Center for Autism and Behavioral Health, part of the E.K. Shriver Center at UMass Chan Medical School, has helpful information and resources on their website, www.massairc.org. They primarily assist Massachusetts residents, but much of their information is also helpful for those who live outside of the state.

Advocate for better coverage!

It’s also a great idea to advocate for better coverage from private insurance, Medicare or mental health parity. Help improve the system - start by contacting legislators through the National Conference of State Legislatures.