The Governor of Ohio, John Kasich, has announced that many health insurance plans in the state will now cover autism services. This is excellent news for families who have been struggling to pay for the treatment their child requires without the help of their health insurance company.
There is no cure for autism, but there are some forms of treatment that can help with certain symptoms. Applied Behavior Analysis, or ABA therapy, is one that can help. It is a scientifically validated approach to understanding behavior and how it is affected by environment. In “plain English”, it can help children who have autism to pick up on the social cues that their peers, who do not have autism, will naturally figure out all on their own.
ABA is an ongoing form of treatment. You cannot simply have one session and expect that this will be enough. Thirty two states require all health plans to cover autism treatment. Sadly, other states have no such requirement. Without it, parents of kids who have autism find themselves struggling to come up with the money to pay for the therapy that their child requires. Autism affects about 1 in every 88 children.
Recently, Governor John Kasich, of Ohio, revealed that the state would join the group of states that require autism coverage. He announced policy changes that would result in more types of health insurance to offer that type of coverage.
Now, the health insurance plans that state employees receive will cover autism treatment. So will health insurance policies that were purchased through private insurers. The Governor noted that health plans that will be purchased through the upcoming health insurance exchanges will also have to provide autism coverage. It is worth mentioning that, previous to this announcement, the state of Ohio already required Medicaid to cover autism services for Medicaid recipients.
What’s covered? All health plans will have to pay for assessments, treatment plans, speech and occupational therapy, and treatment aimed at improving communication and social skills for children who have autism. This will help many families to be able to afford to get what their child needs.
What’s not covered? Some types of health insurance plans are not required to cover autism services at all. Specifically, the plans that are offered to employees by “entities” that are self-insured. Employee health insurance that comes from large group insurers is also not required to cover autism services.
In short, if you live in Ohio, and your child is covered through your employer sponsored health plan, you probably cannot get coverage for autism treatment. However, if you are a state employee, then your health plan will provide coverage for autism services.
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