AZ Autism Insurance Bill Passes

Insurers in the state of Arizona will be mandated to provide coverage for Applied Behavior Analysis beginning in July of 2009.

Arizona joins only a handful of states that mandate insurance coverage for autism spectrum disorders. This legislation, scheduled to go into effect in July 2009, was the result of countless hours of hard work by parents of children with autism. Governor Janet Napolitano signed the legislation on March 21, 2008 to the delight of families across the state.

As it stands now, the majority of insurance companies exclude benefits to individuals with an autism spectrum disorder if the requested treatment is specifically for the autism. Even the staples of autism intervention, speech and occupational therapy, were excluded because they were for habilitation reasons, not rehabilitative. Insurance companies considered these to be educational in nature and felt that the school districts were responsible for providing these services.

Although the bill went through several changes over its lifetime, it still provides mandated coverage for Applied Behavior Analysis. There are a few restrictions on the law:

• The mandate only applies to companies employing more than 50 individuals and does not apply to self-insured businesses.
• ABA is limited to $50,000 per year through age nine and $25,000 per year through age 16.
• Treatments must be considered medically-necessary.

Even with these restrictions, the signing of the bill was considered a breakthrough for families struggling to pay for autism therapies for their children. It is not unheard of for families to take second mortgages on their homes to pay for the very pricey Applied Behavior Analysis therapy. Families in Arizona now have another choice thanks to parents advocating for their children.