Mom Sues Insurers Who Denied Son’s Autism Therapy

gavelIn many states, the cost of applied behavioral analysis, or ABA, therapy is required to be covered in a health insurance plan. In Minnesota, this is not the case. A mother in Minnesota is suing two insurance companies who refused to cover the ABA treatment that her son required.

Applied behavioral analysis, or ABA, is a treatment used with children who have autism. It is an ongoing form of therapy. Several states, including California and Florida, have laws in place that require health insurance plans to cover the cost of ABA treatment.

Sadly, not all states have laws that require insurers to do this. This means that some insurance companies are going to choose to “opt-out” of coverage for ABA. When this happens, parents end up having to come up with the entire cost of the treatment out of their own pocket, (even if they have health insurance coverage). Several lawsuits have been filed in an attempt to have ABA therapy be covered.

Tracy Reid is a mother who lives in Minnesota. She has a seven year old son named Max who has autism. She says that a doctor told her that Max needed behavioral therapy, and so, he began receiving it.

At the time, she had a health insurance policy from HealthPartners. She said that HealthPartners denied coverage for Max’s ABA therapy, due to a contract exclusion.

After that, Tracy Reid switched to a new job. It is common for a person to change jobs and end up changing health insurance companies at the same time. In general, your “old job” could be using one insurance company and your “new job” could be using a completely different one. Since people cannot transfer employer sponsored health insurance from one job to another, the result is that people change insurers when they get a new job.

When Tracy Reid got a new job, she switched from HealthPartners to Blue Cross Blue Shield. She said that Blue Cross Blue Shield covered ABA therapy. But, then, she got a letter from the insurer that said that they will cease to cover ABA therapy as of January 1, 2013.

She has now filed a lawsuit against both HealthPartners and Blue Cross Blue Shield. The lawsuit alleges discrimination under the Americans with Disabilities Act and under the Human Rights Act.

At this time, Max is receiving applied behavioral analysis therapy. Tracy Reid has purchased a health policy through the Minnesota Department of Human Services.

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