Insurance Coverage for Autism Therapy
Posted on August 16th, 2008 by Tariq Nelson
There is currently a bill pending in Virginia to require insurance to cover therapies for Autism currently not covered. This is an important and worthy cause. Sign the petition to ask the Virginia General Assembly to do the right thing and pass HB 83.
Filed under: Children's Issues
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If you have half a brain, you will probably produce half decent comments, and those of us reading Tariq’s blog will in turn visit your blog. Kapiche?
My apologies to Tariq for making this comment.
By law, health insurance policies in Connecticut are required to cover certain mental illnesses. The statute appears to include coverage for the diagnosis and treatment of autism, though it is unclear whether such treatment includes physical, speech, and occupational therapy. The legislature could refine the state insurance laws to specify certain coverage requirements for autism.
Sixteen other states have insurance laws relating to autism coverage, including 10 that require coverage for autism through their laws mandating coverage for mental illness. Six states have specific laws regarding insurance coverage for autism (Georgia, Indiana, Kentucky, Maryland, New York, and Tennessee). A description of those six is included in this report. Copies of the laws are enclosed.
The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) classifies autism within the category of disorders usually diagnosed in infancy, childhood, or adolescence. Specifically, autism is included in a group of pervasive developmental disorders (more recently known as autism spectrum disorders or ASD). ASD also include Asperger syndrome, Rett syndrome, childhood disintegrative disorder, and pervasive developmental disorder not otherwise specified (usually referred to as PDD-NOS). Experts estimate that three to six children out of every 1,000 will have autism and males are four times more likely to have autism than females (National Institute of Neurological Disorders and Stroke, NINDS, which is part of the National Institutes of Health).
Autism, usually diagnosed by age three, is characterized by impaired social interaction, problems with verbal and nonverbal communication, and unusual, repetitive, or severely limited activities and interests. DSM-IV specifically differentiates autism from other classified disorders, including learning, motor skills, communication, and attention deficit disorders.
Scientists are not certain what causes autism, but it is likely that both genetics and environment play a role. Researchers have identified a number of genes associated with the disorder. Studies of autistic people have found irregularities in several regions of the brain. Other studies suggest that people with autism have abnormal levels of serotonin or other neurotransmitters in the brain. These abnormalities suggest that autism could result from the disruption of normal brain development early in fetal development caused by defects in genes that control brain growth and that regulate how neurons communicate with each other. These findings are preliminary and require further study (NINDS).
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Thanks Tariq. As a father of children with Autism a bill like this is the difference between the chance of a normal life and life in a group home or worse. For families it is also the difference between the ability to live okay and the poor house.
I work with a lady who was able to pay for private ABA, but just getting the initial evaluation and starting the program cost $20,000 this last summer. Then the child needs at least 4 hours a day at $25 dollars a day. Do the math.
At least she could drop the $20,000 to get her child started. Most of us cannot do that.