If you have a child who has been recently diagnosed with autism, you no doubt want to know what insurance options you have. Unfortunately, as with most things having to do with insurance, determining which one is best for you is complicated.\u00a0<\/p>\n\n\n\n
The best health insurance option for autism should cover Applied Behavior Analysis (ABA) treatment and cover many other options. Unfortunately, no national standard exists for what coverage companies should provide, so insurance options are based on the laws of the state one lives in. <\/strong><\/p>\n\n\n\n
You either already know or are about to learn that raising autistic children can be awfully expensive. Even though it does not seem fair that navigating the insurance system should be another burden, it probably will be. This guide is designed to help you understand why the system is so complicated and give you some tips on navigating it. <\/p>\n\n\n\n
In this post, we'll cover:<\/p>\n
According to a CDC estimate<\/a>, the average yearly cost for treating and caring for a child on the autism spectrum<\/a> is $17,000 for basic ABA therapy. Additional costs for providing care for a child with autism can bring those costs much higher. One study found that autism therapy<\/a> can cost up to $60,000 a year. <\/p>\n\n\n\n
Why such a discrepancy in these numbers?<\/p>\n\n\n\n
Finally, to manage expenses and help insurance companies set rates, most states set caps on what an insurance company must pay out. These caps vary greatly, from $50,000 in Arkansas to age-based caps in Alabama ($40,000 for ages 0-9 down to $20,000 for children over 14) to a few states with no caps.<\/p>\n\n\n\n
Some states have no spending caps but end coverage at a specific age, either 18 or 21. A few states have no spending or age caps. These caps only apply to state-regulated health benefit plans. If a company has a self-funded health plan, they are not required to follow their state’s autism laws.<\/p>\n\n\n\n
For these reasons, determining how much it will cost to care for a child with autism is difficult.<\/p>\n\n\n\n
Besides the costs of autistic-specific treatment, children who are on the Autism Spectrum Disorder (ASD):<\/p>\n\n\n\n
The following is a shortlist of additional therapies or those a state might cover instead of ABA<\/strong>. <\/p>\n\n\n\n
Medication can be another expense. Some children benefit from medication that helps with anxiety, depression, high energy levels, inability to focus, seizures, or self-injury.<\/p>\n\n\n\n
Then there are the non-medical costs, which include one parent reducing or not working and other financial burdens, not to mention the stress of having to balance work and family responsibilities.<\/p>\n\n\n\n
Due to the challenges of raising a child on the autism spectrum, one would hope insurance companies would make it easy for parents. But often, that is not the case. Not only do reimbursements for treatment depend on where you live, but your insurance type also influences what will and will not be covered.<\/p>\n\n\n\n
The first step to finding out what will be covered determines the kind of insurance coverage you have.\u00a0 \u00a0<\/p>\n\n\n\n