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Coverage includes, therapeutic care, which is habilitative or nonrestorative, provided by a licensed or certified speech therapist. Coverage includes therapeutic care, which includes services provided by a licensed speech-language pathologist. Treatment covers "therapeutic care" provided by licensed or certified speech therapists, occupational therapists or physical therapists. Coverage provided under this section by an insurer shall be subject to a maximum benefit of ,080 per year and is not subject to any limits on the number of visits to an autism service provider for treatment of autism spectrum disorders. The benefits will continue until the covered individual reaches the age of fifteen. The benefits and coverage provided must be provided to any eligible person under sixteen years of age. §38-71-280 Requires all individual and group health insurance policies, contracts and certificates issued by health carriers and self-funded nonfederal governmental plans with the exception of the state employee health plan sponsored by the State of South Dakota to provide coverage for treatment of autism spectrum disorder. If an enrollee who is being treated for autism spectrum disorder becomes 10 years of age or older and continues to need treatment, this does not preclude coverage of treatment and services. Treatment includes: (A) behavioral health treatment; (B) pharmacy care; (C) psychiatric care; (D) psychological care; and (E) therapeutic care. Treatment includes: habilitative or rehabilitative care; pharmacy care; psychiatric care; psychological care; and therapeutic care (includes services provided by licensed or certified speech language pathologists, occupational therapists, physical therapists, or social workers), if the physician or psychologist determines the care to be medically necessary. An individual who is being treated and continues to need treatment for autism spectrum disorder and becomes seven years of age or older is not precluded from coverage of treatment and services. Ann §59A-22-49; §59A-23-7.9; §59A-46-50; §59A-47-45 Requires every policy which provides physician services, medical, major medical or similar comprehensive-type coverage to provide coverage for the screening, diagnosis and treatment of autism spectrum disorder. Isc Law §3216 Requires health benefit plans to provide coverage for the screening, diagnosis, and treatment of autism spectrum disorder. Citation: EHB Benchmark Plan for Ohio [PDF] Requires all plans issued or renewed on or after November 1, 2016, a health benefit plan and the Oklahoma Employees Health Insurance Plan to provide coverage for the screening, diagnosis and treatment of autism spectrum disorder in individuals less than nine (9) years of age, or if an individual is not diagnosed or treated until after three (3) years of age, coverage shall be provided for at least six (6) years, provided that the individual continually and consistently shows sufficient progress and improvement as determined by the health care provider. Rehabilitation services is defined as physical therapy, occupational therapy or speech therapy services to restore or improve function. Treatment includes: pharmacy care, psychiatric care, psychological care, rehabilitative care and therapeutic care (includes services provided by speech language pathologists, occupational therapists or physical therapists) that is medically necessary and prescribed, ordered or provided by a licensed physician, licensed physician assistant, licensed psychologist, licensed clinical social worker or certified registered nurse practitioner. Benefits include coverage for applied behavior analysis, physical therapy, speech therapy and occupational therapy services for the treatment of Autism spectrum disorders. To be eligible for benefits and coverage, an individual must be diagnosed with autistic spectrum disorder at age eight or younger. Codified Laws §58-17 [PDF] (as amended by SB 190 [2015]) Requires a health benefit plan to provide coverage to an enrollee who is diagnosed with autism spectrum disorder from the date of diagnosis until the enrollee completes nine years of age. §1355.015 Effective January 1, 2016, requires a health benefit plan offered or renewed in the individual market or large group market to provide coverage for the treatment of autism spectrum disorder for children 2 to 9 years of age. 57 (2014)] Requires a health insurance plan to provide coverage for the diagnosis and treatment of autism spectrum disorders, including applied behavior analysis supervised by a nationally board-certified behavior analyst, for children, beginning at 18 months of age and continuing until the child reaches age six or enters the first grade, whichever occurs first. 8 § 4088i Requires health insurance plans issued or renewed after January 1, 2012, to provide coverage for the diagnosis and the treatment of autism spectrum disorder in individuals from age two through age six. §417-E:2 Requires specified health insurance policies and health benefit plans to provide benefits for treatment of autism or other developmental disability. Coverage is "limited to treatment that is prescribed by the insured's treating medical doctor in accordance with a treatment plan." Although behavioral therapy is not specifically defined, the statute does set out a cap of ,000 per year for coverage of behavioral therapy. Certain insurers may be exempt from requirements for 1 year and may reapply for the exemption yearly. The order also covers new health plan sold through the state healthcare marketplace created under the Affordable Care Act. §-6ii; Requires specified health insurance policy, health care plan or certificate of health insurance shall provide coverage to an eligible individual who is nineteen years of age or younger, or an eligible individual who is twenty-two years of age or younger and is enrolled in high school, for: Coverage shall be limited to ,000 annually and shall not exceed 0,000 in total lifetime benefits. Note: Speech language services are not specifically defined in the statute. Treatment means evidence-based care which is prescribed or ordered for a person diagnosed with an autism spectrum disorder by a licensed physician or psychologist, including: behavioral health treatment; pharmacy care; and therapeutic care. Treatment may include services such as: evaluation and assessment services; applied behavior analysis; behavior training and behavior management; speech therapy; occupational therapy; physical therapy; or medications or nutritional supplements used to address symptoms of autism spectrum disorder. Therapeutic care means services provided by licensed or certified speech therapists, occupational therapists, or physical therapists. The provisions go into effect on or after July 1, 2011, on such date as a health insurer offers, issues, or renews the health insurance plan, but in no event later than July 1, 2012. Treatment shall be determined by a licensed physician or a licensed psychologist to be medically necessary, and includes: (i) behavioral health treatment, (ii) pharmacy care, (iii) psychiatric care, (iv) psychological care, (v) therapeutic care (which includes services provided by licensed or certified speech therapists, occupational therapists, physical therapists, or clinical social workers), and (vi) applied behavior analysis when provided or supervised by a board certified behavior analyst who shall be licensed by the Board of Medicine. § 38.2-3418.17 As the result of litigation, Washington state Insurance Commissioner, Mike Kreidler, directed all state-regulated private health plans to provide coverage for medically necessary treatment of autism, including coverage of speech, occupational, physical and ABA therapy.Requirements vary state by state for Existing laws in these states are summarized below with a link to each statute. Please be advised that laws, regulations, and policies may change at any time, so always check with your state for the most up-to-date information. Any additional amounts payable to the hearing aid provider shall be paid by the covered individual. Requires insurance companies to offer coverage to employers in the state. 18 § 3357 Requires health benefit policy to provide coverage of up to ,000 per ear every 48 months for covered individuals 18 years and under. Your support enables the Guttmacher Institute to advance sexual and reproductive health and rights in the United States and globally through our interrelated program of high-quality research, evidence-based advocacy and strategic communications.Colorado, Delaware, Georgia, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Minnesota, Missouri, New Jersey, New Mexico, North Carolina, Oklahoma, Oregon, Tennessee, and Texas require that health benefits plans in their state pay for hearing aids for children. 5/356z.29 (as created by HB 4516 (2018)) Requires health benefit plans to provide coverage for the full cost of one hearing aid per hearing-impaired ear up to

Coverage includes, therapeutic care, which is habilitative or nonrestorative, provided by a licensed or certified speech therapist. Coverage includes therapeutic care, which includes services provided by a licensed speech-language pathologist. Treatment covers "therapeutic care" provided by licensed or certified speech therapists, occupational therapists or physical therapists. Coverage provided under this section by an insurer shall be subject to a maximum benefit of $37,080 per year and is not subject to any limits on the number of visits to an autism service provider for treatment of autism spectrum disorders. The benefits will continue until the covered individual reaches the age of fifteen. The benefits and coverage provided must be provided to any eligible person under sixteen years of age. §38-71-280 Requires all individual and group health insurance policies, contracts and certificates issued by health carriers and self-funded nonfederal governmental plans with the exception of the state employee health plan sponsored by the State of South Dakota to provide coverage for treatment of autism spectrum disorder. If an enrollee who is being treated for autism spectrum disorder becomes 10 years of age or older and continues to need treatment, this does not preclude coverage of treatment and services. Treatment includes: (A) behavioral health treatment; (B) pharmacy care; (C) psychiatric care; (D) psychological care; and (E) therapeutic care. Treatment includes: habilitative or rehabilitative care; pharmacy care; psychiatric care; psychological care; and therapeutic care (includes services provided by licensed or certified speech language pathologists, occupational therapists, physical therapists, or social workers), if the physician or psychologist determines the care to be medically necessary. An individual who is being treated and continues to need treatment for autism spectrum disorder and becomes seven years of age or older is not precluded from coverage of treatment and services. Ann §59A-22-49; §59A-23-7.9; §59A-46-50; §59A-47-45 Requires every policy which provides physician services, medical, major medical or similar comprehensive-type coverage to provide coverage for the screening, diagnosis and treatment of autism spectrum disorder. Isc Law §3216 Requires health benefit plans to provide coverage for the screening, diagnosis, and treatment of autism spectrum disorder. Citation: EHB Benchmark Plan for Ohio [PDF] Requires all plans issued or renewed on or after November 1, 2016, a health benefit plan and the Oklahoma Employees Health Insurance Plan to provide coverage for the screening, diagnosis and treatment of autism spectrum disorder in individuals less than nine (9) years of age, or if an individual is not diagnosed or treated until after three (3) years of age, coverage shall be provided for at least six (6) years, provided that the individual continually and consistently shows sufficient progress and improvement as determined by the health care provider. Rehabilitation services is defined as physical therapy, occupational therapy or speech therapy services to restore or improve function. Treatment includes: pharmacy care, psychiatric care, psychological care, rehabilitative care and therapeutic care (includes services provided by speech language pathologists, occupational therapists or physical therapists) that is medically necessary and prescribed, ordered or provided by a licensed physician, licensed physician assistant, licensed psychologist, licensed clinical social worker or certified registered nurse practitioner. Benefits include coverage for applied behavior analysis, physical therapy, speech therapy and occupational therapy services for the treatment of Autism spectrum disorders. To be eligible for benefits and coverage, an individual must be diagnosed with autistic spectrum disorder at age eight or younger. Codified Laws §58-17 [PDF] (as amended by SB 190 [2015]) Requires a health benefit plan to provide coverage to an enrollee who is diagnosed with autism spectrum disorder from the date of diagnosis until the enrollee completes nine years of age. §1355.015 Effective January 1, 2016, requires a health benefit plan offered or renewed in the individual market or large group market to provide coverage for the treatment of autism spectrum disorder for children 2 to 9 years of age. 57 (2014)] Requires a health insurance plan to provide coverage for the diagnosis and treatment of autism spectrum disorders, including applied behavior analysis supervised by a nationally board-certified behavior analyst, for children, beginning at 18 months of age and continuing until the child reaches age six or enters the first grade, whichever occurs first. 8 § 4088i Requires health insurance plans issued or renewed after January 1, 2012, to provide coverage for the diagnosis and the treatment of autism spectrum disorder in individuals from age two through age six. §417-E:2 Requires specified health insurance policies and health benefit plans to provide benefits for treatment of autism or other developmental disability. Coverage is "limited to treatment that is prescribed by the insured's treating medical doctor in accordance with a treatment plan." Although behavioral therapy is not specifically defined, the statute does set out a cap of $50,000 per year for coverage of behavioral therapy. Certain insurers may be exempt from requirements for 1 year and may reapply for the exemption yearly. The order also covers new health plan sold through the state healthcare marketplace created under the Affordable Care Act. §-6ii; Requires specified health insurance policy, health care plan or certificate of health insurance shall provide coverage to an eligible individual who is nineteen years of age or younger, or an eligible individual who is twenty-two years of age or younger and is enrolled in high school, for: Coverage shall be limited to $36,000 annually and shall not exceed $200,000 in total lifetime benefits. Note: Speech language services are not specifically defined in the statute. Treatment means evidence-based care which is prescribed or ordered for a person diagnosed with an autism spectrum disorder by a licensed physician or psychologist, including: behavioral health treatment; pharmacy care; and therapeutic care. Treatment may include services such as: evaluation and assessment services; applied behavior analysis; behavior training and behavior management; speech therapy; occupational therapy; physical therapy; or medications or nutritional supplements used to address symptoms of autism spectrum disorder. Therapeutic care means services provided by licensed or certified speech therapists, occupational therapists, or physical therapists. The provisions go into effect on or after July 1, 2011, on such date as a health insurer offers, issues, or renews the health insurance plan, but in no event later than July 1, 2012. Treatment shall be determined by a licensed physician or a licensed psychologist to be medically necessary, and includes: (i) behavioral health treatment, (ii) pharmacy care, (iii) psychiatric care, (iv) psychological care, (v) therapeutic care (which includes services provided by licensed or certified speech therapists, occupational therapists, physical therapists, or clinical social workers), and (vi) applied behavior analysis when provided or supervised by a board certified behavior analyst who shall be licensed by the Board of Medicine. § 38.2-3418.17 As the result of litigation, Washington state Insurance Commissioner, Mike Kreidler, directed all state-regulated private health plans to provide coverage for medically necessary treatment of autism, including coverage of speech, occupational, physical and ABA therapy.Requirements vary state by state for Existing laws in these states are summarized below with a link to each statute. Please be advised that laws, regulations, and policies may change at any time, so always check with your state for the most up-to-date information. Any additional amounts payable to the hearing aid provider shall be paid by the covered individual. Requires insurance companies to offer coverage to employers in the state. 18 § 3357 Requires health benefit policy to provide coverage of up to $3,000 per ear every 48 months for covered individuals 18 years and under. Your support enables the Guttmacher Institute to advance sexual and reproductive health and rights in the United States and globally through our interrelated program of high-quality research, evidence-based advocacy and strategic communications.Colorado, Delaware, Georgia, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Minnesota, Missouri, New Jersey, New Mexico, North Carolina, Oklahoma, Oregon, Tennessee, and Texas require that health benefits plans in their state pay for hearing aids for children. 5/356z.29 (as created by HB 4516 (2018)) Requires health benefit plans to provide coverage for the full cost of one hearing aid per hearing-impaired ear up to $1,400 every 36 months for individuals under 18 years of age as needed, and all related services necessary to assess, select, and fit the hearing aid. The insurer may limit the benefit payable to $1,400 per hearing aid for each hearing-impaired ear every 36 months. § 38 Requires health insurance policies to provide coverage for hearing aids for children up to age 18; coverage may be limited to $1,400 per hearing aid every 36 months. Coverage includes fitting and dispensing services, including providing ear molds as necessary to maintain optimal fit, provided by an audiologist, a hearing aid dispenser or a physician, licensed in New Mexico. Ann.§ 13-7-10; § 59A-22-34.5; § 59A-23-7.8; § 59A-46-38.5; § 59A-47-37.1 Effective January 1, 2011, health plans are required to provide coverage for one hearing aid per hearing-impaired ear up to two thousand five hundred dollars ($2,500) per hearing aid every 36 months for covered individuals under the age of 22 years. Coverage is limited to one hearing aid in each every three years and one cochlear implant in each ear with internal replacement as medically or audiologically necessary.

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Coverage includes, therapeutic care, which is habilitative or nonrestorative, provided by a licensed or certified speech therapist. Coverage includes therapeutic care, which includes services provided by a licensed speech-language pathologist. Treatment covers "therapeutic care" provided by licensed or certified speech therapists, occupational therapists or physical therapists. Coverage provided under this section by an insurer shall be subject to a maximum benefit of $37,080 per year and is not subject to any limits on the number of visits to an autism service provider for treatment of autism spectrum disorders. The benefits will continue until the covered individual reaches the age of fifteen. The benefits and coverage provided must be provided to any eligible person under sixteen years of age. §38-71-280 Requires all individual and group health insurance policies, contracts and certificates issued by health carriers and self-funded nonfederal governmental plans with the exception of the state employee health plan sponsored by the State of South Dakota to provide coverage for treatment of autism spectrum disorder. If an enrollee who is being treated for autism spectrum disorder becomes 10 years of age or older and continues to need treatment, this does not preclude coverage of treatment and services. Treatment includes: (A) behavioral health treatment; (B) pharmacy care; (C) psychiatric care; (D) psychological care; and (E) therapeutic care. Treatment includes: habilitative or rehabilitative care; pharmacy care; psychiatric care; psychological care; and therapeutic care (includes services provided by licensed or certified speech language pathologists, occupational therapists, physical therapists, or social workers), if the physician or psychologist determines the care to be medically necessary. An individual who is being treated and continues to need treatment for autism spectrum disorder and becomes seven years of age or older is not precluded from coverage of treatment and services.

Ann §59A-22-49; §59A-23-7.9; §59A-46-50; §59A-47-45 Requires every policy which provides physician services, medical, major medical or similar comprehensive-type coverage to provide coverage for the screening, diagnosis and treatment of autism spectrum disorder. Isc Law §3216 Requires health benefit plans to provide coverage for the screening, diagnosis, and treatment of autism spectrum disorder. Citation: EHB Benchmark Plan for Ohio [PDF] Requires all plans issued or renewed on or after November 1, 2016, a health benefit plan and the Oklahoma Employees Health Insurance Plan to provide coverage for the screening, diagnosis and treatment of autism spectrum disorder in individuals less than nine (9) years of age, or if an individual is not diagnosed or treated until after three (3) years of age, coverage shall be provided for at least six (6) years, provided that the individual continually and consistently shows sufficient progress and improvement as determined by the health care provider. Rehabilitation services is defined as physical therapy, occupational therapy or speech therapy services to restore or improve function. Treatment includes: pharmacy care, psychiatric care, psychological care, rehabilitative care and therapeutic care (includes services provided by speech language pathologists, occupational therapists or physical therapists) that is medically necessary and prescribed, ordered or provided by a licensed physician, licensed physician assistant, licensed psychologist, licensed clinical social worker or certified registered nurse practitioner. Benefits include coverage for applied behavior analysis, physical therapy, speech therapy and occupational therapy services for the treatment of Autism spectrum disorders. To be eligible for benefits and coverage, an individual must be diagnosed with autistic spectrum disorder at age eight or younger. Codified Laws §58-17 [PDF] (as amended by SB 190 [2015]) Requires a health benefit plan to provide coverage to an enrollee who is diagnosed with autism spectrum disorder from the date of diagnosis until the enrollee completes nine years of age. §1355.015 Effective January 1, 2016, requires a health benefit plan offered or renewed in the individual market or large group market to provide coverage for the treatment of autism spectrum disorder for children 2 to 9 years of age. 57 (2014)] Requires a health insurance plan to provide coverage for the diagnosis and treatment of autism spectrum disorders, including applied behavior analysis supervised by a nationally board-certified behavior analyst, for children, beginning at 18 months of age and continuing until the child reaches age six or enters the first grade, whichever occurs first. 8 § 4088i Requires health insurance plans issued or renewed after January 1, 2012, to provide coverage for the diagnosis and the treatment of autism spectrum disorder in individuals from age two through age six.

§417-E:2 Requires specified health insurance policies and health benefit plans to provide benefits for treatment of autism or other developmental disability. Coverage is "limited to treatment that is prescribed by the insured's treating medical doctor in accordance with a treatment plan." Although behavioral therapy is not specifically defined, the statute does set out a cap of $50,000 per year for coverage of behavioral therapy. Certain insurers may be exempt from requirements for 1 year and may reapply for the exemption yearly. The order also covers new health plan sold through the state healthcare marketplace created under the Affordable Care Act.

§-6ii; Requires specified health insurance policy, health care plan or certificate of health insurance shall provide coverage to an eligible individual who is nineteen years of age or younger, or an eligible individual who is twenty-two years of age or younger and is enrolled in high school, for: Coverage shall be limited to $36,000 annually and shall not exceed $200,000 in total lifetime benefits. Note: Speech language services are not specifically defined in the statute. Treatment means evidence-based care which is prescribed or ordered for a person diagnosed with an autism spectrum disorder by a licensed physician or psychologist, including: behavioral health treatment; pharmacy care; and therapeutic care. Treatment may include services such as: evaluation and assessment services; applied behavior analysis; behavior training and behavior management; speech therapy; occupational therapy; physical therapy; or medications or nutritional supplements used to address symptoms of autism spectrum disorder. Therapeutic care means services provided by licensed or certified speech therapists, occupational therapists, or physical therapists. The provisions go into effect on or after July 1, 2011, on such date as a health insurer offers, issues, or renews the health insurance plan, but in no event later than July 1, 2012. Treatment shall be determined by a licensed physician or a licensed psychologist to be medically necessary, and includes: (i) behavioral health treatment, (ii) pharmacy care, (iii) psychiatric care, (iv) psychological care, (v) therapeutic care (which includes services provided by licensed or certified speech therapists, occupational therapists, physical therapists, or clinical social workers), and (vi) applied behavior analysis when provided or supervised by a board certified behavior analyst who shall be licensed by the Board of Medicine. § 38.2-3418.17 As the result of litigation, Washington state Insurance Commissioner, Mike Kreidler, directed all state-regulated private health plans to provide coverage for medically necessary treatment of autism, including coverage of speech, occupational, physical and ABA therapy.

Requirements vary state by state for Existing laws in these states are summarized below with a link to each statute. Please be advised that laws, regulations, and policies may change at any time, so always check with your state for the most up-to-date information. Any additional amounts payable to the hearing aid provider shall be paid by the covered individual.

,400 every 36 months for individuals under 18 years of age as needed, and all related services necessary to assess, select, and fit the hearing aid. The insurer may limit the benefit payable to

Coverage includes, therapeutic care, which is habilitative or nonrestorative, provided by a licensed or certified speech therapist. Coverage includes therapeutic care, which includes services provided by a licensed speech-language pathologist. Treatment covers "therapeutic care" provided by licensed or certified speech therapists, occupational therapists or physical therapists. Coverage provided under this section by an insurer shall be subject to a maximum benefit of $37,080 per year and is not subject to any limits on the number of visits to an autism service provider for treatment of autism spectrum disorders. The benefits will continue until the covered individual reaches the age of fifteen. The benefits and coverage provided must be provided to any eligible person under sixteen years of age. §38-71-280 Requires all individual and group health insurance policies, contracts and certificates issued by health carriers and self-funded nonfederal governmental plans with the exception of the state employee health plan sponsored by the State of South Dakota to provide coverage for treatment of autism spectrum disorder. If an enrollee who is being treated for autism spectrum disorder becomes 10 years of age or older and continues to need treatment, this does not preclude coverage of treatment and services. Treatment includes: (A) behavioral health treatment; (B) pharmacy care; (C) psychiatric care; (D) psychological care; and (E) therapeutic care. Treatment includes: habilitative or rehabilitative care; pharmacy care; psychiatric care; psychological care; and therapeutic care (includes services provided by licensed or certified speech language pathologists, occupational therapists, physical therapists, or social workers), if the physician or psychologist determines the care to be medically necessary. An individual who is being treated and continues to need treatment for autism spectrum disorder and becomes seven years of age or older is not precluded from coverage of treatment and services. Ann §59A-22-49; §59A-23-7.9; §59A-46-50; §59A-47-45 Requires every policy which provides physician services, medical, major medical or similar comprehensive-type coverage to provide coverage for the screening, diagnosis and treatment of autism spectrum disorder. Isc Law §3216 Requires health benefit plans to provide coverage for the screening, diagnosis, and treatment of autism spectrum disorder. Citation: EHB Benchmark Plan for Ohio [PDF] Requires all plans issued or renewed on or after November 1, 2016, a health benefit plan and the Oklahoma Employees Health Insurance Plan to provide coverage for the screening, diagnosis and treatment of autism spectrum disorder in individuals less than nine (9) years of age, or if an individual is not diagnosed or treated until after three (3) years of age, coverage shall be provided for at least six (6) years, provided that the individual continually and consistently shows sufficient progress and improvement as determined by the health care provider. Rehabilitation services is defined as physical therapy, occupational therapy or speech therapy services to restore or improve function. Treatment includes: pharmacy care, psychiatric care, psychological care, rehabilitative care and therapeutic care (includes services provided by speech language pathologists, occupational therapists or physical therapists) that is medically necessary and prescribed, ordered or provided by a licensed physician, licensed physician assistant, licensed psychologist, licensed clinical social worker or certified registered nurse practitioner. Benefits include coverage for applied behavior analysis, physical therapy, speech therapy and occupational therapy services for the treatment of Autism spectrum disorders. To be eligible for benefits and coverage, an individual must be diagnosed with autistic spectrum disorder at age eight or younger. Codified Laws §58-17 [PDF] (as amended by SB 190 [2015]) Requires a health benefit plan to provide coverage to an enrollee who is diagnosed with autism spectrum disorder from the date of diagnosis until the enrollee completes nine years of age. §1355.015 Effective January 1, 2016, requires a health benefit plan offered or renewed in the individual market or large group market to provide coverage for the treatment of autism spectrum disorder for children 2 to 9 years of age. 57 (2014)] Requires a health insurance plan to provide coverage for the diagnosis and treatment of autism spectrum disorders, including applied behavior analysis supervised by a nationally board-certified behavior analyst, for children, beginning at 18 months of age and continuing until the child reaches age six or enters the first grade, whichever occurs first. 8 § 4088i Requires health insurance plans issued or renewed after January 1, 2012, to provide coverage for the diagnosis and the treatment of autism spectrum disorder in individuals from age two through age six. §417-E:2 Requires specified health insurance policies and health benefit plans to provide benefits for treatment of autism or other developmental disability. Coverage is "limited to treatment that is prescribed by the insured's treating medical doctor in accordance with a treatment plan." Although behavioral therapy is not specifically defined, the statute does set out a cap of $50,000 per year for coverage of behavioral therapy. Certain insurers may be exempt from requirements for 1 year and may reapply for the exemption yearly. The order also covers new health plan sold through the state healthcare marketplace created under the Affordable Care Act. §-6ii; Requires specified health insurance policy, health care plan or certificate of health insurance shall provide coverage to an eligible individual who is nineteen years of age or younger, or an eligible individual who is twenty-two years of age or younger and is enrolled in high school, for: Coverage shall be limited to $36,000 annually and shall not exceed $200,000 in total lifetime benefits. Note: Speech language services are not specifically defined in the statute. Treatment means evidence-based care which is prescribed or ordered for a person diagnosed with an autism spectrum disorder by a licensed physician or psychologist, including: behavioral health treatment; pharmacy care; and therapeutic care. Treatment may include services such as: evaluation and assessment services; applied behavior analysis; behavior training and behavior management; speech therapy; occupational therapy; physical therapy; or medications or nutritional supplements used to address symptoms of autism spectrum disorder. Therapeutic care means services provided by licensed or certified speech therapists, occupational therapists, or physical therapists. The provisions go into effect on or after July 1, 2011, on such date as a health insurer offers, issues, or renews the health insurance plan, but in no event later than July 1, 2012. Treatment shall be determined by a licensed physician or a licensed psychologist to be medically necessary, and includes: (i) behavioral health treatment, (ii) pharmacy care, (iii) psychiatric care, (iv) psychological care, (v) therapeutic care (which includes services provided by licensed or certified speech therapists, occupational therapists, physical therapists, or clinical social workers), and (vi) applied behavior analysis when provided or supervised by a board certified behavior analyst who shall be licensed by the Board of Medicine. § 38.2-3418.17 As the result of litigation, Washington state Insurance Commissioner, Mike Kreidler, directed all state-regulated private health plans to provide coverage for medically necessary treatment of autism, including coverage of speech, occupational, physical and ABA therapy.Requirements vary state by state for Existing laws in these states are summarized below with a link to each statute. Please be advised that laws, regulations, and policies may change at any time, so always check with your state for the most up-to-date information. Any additional amounts payable to the hearing aid provider shall be paid by the covered individual. Requires insurance companies to offer coverage to employers in the state. 18 § 3357 Requires health benefit policy to provide coverage of up to $3,000 per ear every 48 months for covered individuals 18 years and under. Your support enables the Guttmacher Institute to advance sexual and reproductive health and rights in the United States and globally through our interrelated program of high-quality research, evidence-based advocacy and strategic communications.Colorado, Delaware, Georgia, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Minnesota, Missouri, New Jersey, New Mexico, North Carolina, Oklahoma, Oregon, Tennessee, and Texas require that health benefits plans in their state pay for hearing aids for children. 5/356z.29 (as created by HB 4516 (2018)) Requires health benefit plans to provide coverage for the full cost of one hearing aid per hearing-impaired ear up to $1,400 every 36 months for individuals under 18 years of age as needed, and all related services necessary to assess, select, and fit the hearing aid. The insurer may limit the benefit payable to $1,400 per hearing aid for each hearing-impaired ear every 36 months. § 38 Requires health insurance policies to provide coverage for hearing aids for children up to age 18; coverage may be limited to $1,400 per hearing aid every 36 months. Coverage includes fitting and dispensing services, including providing ear molds as necessary to maintain optimal fit, provided by an audiologist, a hearing aid dispenser or a physician, licensed in New Mexico. Ann.§ 13-7-10; § 59A-22-34.5; § 59A-23-7.8; § 59A-46-38.5; § 59A-47-37.1 Effective January 1, 2011, health plans are required to provide coverage for one hearing aid per hearing-impaired ear up to two thousand five hundred dollars ($2,500) per hearing aid every 36 months for covered individuals under the age of 22 years. Coverage is limited to one hearing aid in each every three years and one cochlear implant in each ear with internal replacement as medically or audiologically necessary.

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Coverage includes, therapeutic care, which is habilitative or nonrestorative, provided by a licensed or certified speech therapist. Coverage includes therapeutic care, which includes services provided by a licensed speech-language pathologist. Treatment covers "therapeutic care" provided by licensed or certified speech therapists, occupational therapists or physical therapists. Coverage provided under this section by an insurer shall be subject to a maximum benefit of $37,080 per year and is not subject to any limits on the number of visits to an autism service provider for treatment of autism spectrum disorders. The benefits will continue until the covered individual reaches the age of fifteen. The benefits and coverage provided must be provided to any eligible person under sixteen years of age. §38-71-280 Requires all individual and group health insurance policies, contracts and certificates issued by health carriers and self-funded nonfederal governmental plans with the exception of the state employee health plan sponsored by the State of South Dakota to provide coverage for treatment of autism spectrum disorder. If an enrollee who is being treated for autism spectrum disorder becomes 10 years of age or older and continues to need treatment, this does not preclude coverage of treatment and services. Treatment includes: (A) behavioral health treatment; (B) pharmacy care; (C) psychiatric care; (D) psychological care; and (E) therapeutic care. Treatment includes: habilitative or rehabilitative care; pharmacy care; psychiatric care; psychological care; and therapeutic care (includes services provided by licensed or certified speech language pathologists, occupational therapists, physical therapists, or social workers), if the physician or psychologist determines the care to be medically necessary. An individual who is being treated and continues to need treatment for autism spectrum disorder and becomes seven years of age or older is not precluded from coverage of treatment and services.

Ann §59A-22-49; §59A-23-7.9; §59A-46-50; §59A-47-45 Requires every policy which provides physician services, medical, major medical or similar comprehensive-type coverage to provide coverage for the screening, diagnosis and treatment of autism spectrum disorder. Isc Law §3216 Requires health benefit plans to provide coverage for the screening, diagnosis, and treatment of autism spectrum disorder. Citation: EHB Benchmark Plan for Ohio [PDF] Requires all plans issued or renewed on or after November 1, 2016, a health benefit plan and the Oklahoma Employees Health Insurance Plan to provide coverage for the screening, diagnosis and treatment of autism spectrum disorder in individuals less than nine (9) years of age, or if an individual is not diagnosed or treated until after three (3) years of age, coverage shall be provided for at least six (6) years, provided that the individual continually and consistently shows sufficient progress and improvement as determined by the health care provider. Rehabilitation services is defined as physical therapy, occupational therapy or speech therapy services to restore or improve function. Treatment includes: pharmacy care, psychiatric care, psychological care, rehabilitative care and therapeutic care (includes services provided by speech language pathologists, occupational therapists or physical therapists) that is medically necessary and prescribed, ordered or provided by a licensed physician, licensed physician assistant, licensed psychologist, licensed clinical social worker or certified registered nurse practitioner. Benefits include coverage for applied behavior analysis, physical therapy, speech therapy and occupational therapy services for the treatment of Autism spectrum disorders. To be eligible for benefits and coverage, an individual must be diagnosed with autistic spectrum disorder at age eight or younger. Codified Laws §58-17 [PDF] (as amended by SB 190 [2015]) Requires a health benefit plan to provide coverage to an enrollee who is diagnosed with autism spectrum disorder from the date of diagnosis until the enrollee completes nine years of age. §1355.015 Effective January 1, 2016, requires a health benefit plan offered or renewed in the individual market or large group market to provide coverage for the treatment of autism spectrum disorder for children 2 to 9 years of age. 57 (2014)] Requires a health insurance plan to provide coverage for the diagnosis and treatment of autism spectrum disorders, including applied behavior analysis supervised by a nationally board-certified behavior analyst, for children, beginning at 18 months of age and continuing until the child reaches age six or enters the first grade, whichever occurs first. 8 § 4088i Requires health insurance plans issued or renewed after January 1, 2012, to provide coverage for the diagnosis and the treatment of autism spectrum disorder in individuals from age two through age six.

§417-E:2 Requires specified health insurance policies and health benefit plans to provide benefits for treatment of autism or other developmental disability. Coverage is "limited to treatment that is prescribed by the insured's treating medical doctor in accordance with a treatment plan." Although behavioral therapy is not specifically defined, the statute does set out a cap of $50,000 per year for coverage of behavioral therapy. Certain insurers may be exempt from requirements for 1 year and may reapply for the exemption yearly. The order also covers new health plan sold through the state healthcare marketplace created under the Affordable Care Act.

§-6ii; Requires specified health insurance policy, health care plan or certificate of health insurance shall provide coverage to an eligible individual who is nineteen years of age or younger, or an eligible individual who is twenty-two years of age or younger and is enrolled in high school, for: Coverage shall be limited to $36,000 annually and shall not exceed $200,000 in total lifetime benefits. Note: Speech language services are not specifically defined in the statute. Treatment means evidence-based care which is prescribed or ordered for a person diagnosed with an autism spectrum disorder by a licensed physician or psychologist, including: behavioral health treatment; pharmacy care; and therapeutic care. Treatment may include services such as: evaluation and assessment services; applied behavior analysis; behavior training and behavior management; speech therapy; occupational therapy; physical therapy; or medications or nutritional supplements used to address symptoms of autism spectrum disorder. Therapeutic care means services provided by licensed or certified speech therapists, occupational therapists, or physical therapists. The provisions go into effect on or after July 1, 2011, on such date as a health insurer offers, issues, or renews the health insurance plan, but in no event later than July 1, 2012. Treatment shall be determined by a licensed physician or a licensed psychologist to be medically necessary, and includes: (i) behavioral health treatment, (ii) pharmacy care, (iii) psychiatric care, (iv) psychological care, (v) therapeutic care (which includes services provided by licensed or certified speech therapists, occupational therapists, physical therapists, or clinical social workers), and (vi) applied behavior analysis when provided or supervised by a board certified behavior analyst who shall be licensed by the Board of Medicine. § 38.2-3418.17 As the result of litigation, Washington state Insurance Commissioner, Mike Kreidler, directed all state-regulated private health plans to provide coverage for medically necessary treatment of autism, including coverage of speech, occupational, physical and ABA therapy.

Requirements vary state by state for Existing laws in these states are summarized below with a link to each statute. Please be advised that laws, regulations, and policies may change at any time, so always check with your state for the most up-to-date information. Any additional amounts payable to the hearing aid provider shall be paid by the covered individual.

,400 per hearing aid for each hearing-impaired ear every 36 months. § 38 Requires health insurance policies to provide coverage for hearing aids for children up to age 18; coverage may be limited to

Coverage includes, therapeutic care, which is habilitative or nonrestorative, provided by a licensed or certified speech therapist. Coverage includes therapeutic care, which includes services provided by a licensed speech-language pathologist. Treatment covers "therapeutic care" provided by licensed or certified speech therapists, occupational therapists or physical therapists. Coverage provided under this section by an insurer shall be subject to a maximum benefit of $37,080 per year and is not subject to any limits on the number of visits to an autism service provider for treatment of autism spectrum disorders. The benefits will continue until the covered individual reaches the age of fifteen. The benefits and coverage provided must be provided to any eligible person under sixteen years of age. §38-71-280 Requires all individual and group health insurance policies, contracts and certificates issued by health carriers and self-funded nonfederal governmental plans with the exception of the state employee health plan sponsored by the State of South Dakota to provide coverage for treatment of autism spectrum disorder. If an enrollee who is being treated for autism spectrum disorder becomes 10 years of age or older and continues to need treatment, this does not preclude coverage of treatment and services. Treatment includes: (A) behavioral health treatment; (B) pharmacy care; (C) psychiatric care; (D) psychological care; and (E) therapeutic care. Treatment includes: habilitative or rehabilitative care; pharmacy care; psychiatric care; psychological care; and therapeutic care (includes services provided by licensed or certified speech language pathologists, occupational therapists, physical therapists, or social workers), if the physician or psychologist determines the care to be medically necessary. An individual who is being treated and continues to need treatment for autism spectrum disorder and becomes seven years of age or older is not precluded from coverage of treatment and services. Ann §59A-22-49; §59A-23-7.9; §59A-46-50; §59A-47-45 Requires every policy which provides physician services, medical, major medical or similar comprehensive-type coverage to provide coverage for the screening, diagnosis and treatment of autism spectrum disorder. Isc Law §3216 Requires health benefit plans to provide coverage for the screening, diagnosis, and treatment of autism spectrum disorder. Citation: EHB Benchmark Plan for Ohio [PDF] Requires all plans issued or renewed on or after November 1, 2016, a health benefit plan and the Oklahoma Employees Health Insurance Plan to provide coverage for the screening, diagnosis and treatment of autism spectrum disorder in individuals less than nine (9) years of age, or if an individual is not diagnosed or treated until after three (3) years of age, coverage shall be provided for at least six (6) years, provided that the individual continually and consistently shows sufficient progress and improvement as determined by the health care provider. Rehabilitation services is defined as physical therapy, occupational therapy or speech therapy services to restore or improve function. Treatment includes: pharmacy care, psychiatric care, psychological care, rehabilitative care and therapeutic care (includes services provided by speech language pathologists, occupational therapists or physical therapists) that is medically necessary and prescribed, ordered or provided by a licensed physician, licensed physician assistant, licensed psychologist, licensed clinical social worker or certified registered nurse practitioner. Benefits include coverage for applied behavior analysis, physical therapy, speech therapy and occupational therapy services for the treatment of Autism spectrum disorders. To be eligible for benefits and coverage, an individual must be diagnosed with autistic spectrum disorder at age eight or younger. Codified Laws §58-17 [PDF] (as amended by SB 190 [2015]) Requires a health benefit plan to provide coverage to an enrollee who is diagnosed with autism spectrum disorder from the date of diagnosis until the enrollee completes nine years of age. §1355.015 Effective January 1, 2016, requires a health benefit plan offered or renewed in the individual market or large group market to provide coverage for the treatment of autism spectrum disorder for children 2 to 9 years of age. 57 (2014)] Requires a health insurance plan to provide coverage for the diagnosis and treatment of autism spectrum disorders, including applied behavior analysis supervised by a nationally board-certified behavior analyst, for children, beginning at 18 months of age and continuing until the child reaches age six or enters the first grade, whichever occurs first. 8 § 4088i Requires health insurance plans issued or renewed after January 1, 2012, to provide coverage for the diagnosis and the treatment of autism spectrum disorder in individuals from age two through age six. §417-E:2 Requires specified health insurance policies and health benefit plans to provide benefits for treatment of autism or other developmental disability. Coverage is "limited to treatment that is prescribed by the insured's treating medical doctor in accordance with a treatment plan." Although behavioral therapy is not specifically defined, the statute does set out a cap of $50,000 per year for coverage of behavioral therapy. Certain insurers may be exempt from requirements for 1 year and may reapply for the exemption yearly. The order also covers new health plan sold through the state healthcare marketplace created under the Affordable Care Act. §-6ii; Requires specified health insurance policy, health care plan or certificate of health insurance shall provide coverage to an eligible individual who is nineteen years of age or younger, or an eligible individual who is twenty-two years of age or younger and is enrolled in high school, for: Coverage shall be limited to $36,000 annually and shall not exceed $200,000 in total lifetime benefits. Note: Speech language services are not specifically defined in the statute. Treatment means evidence-based care which is prescribed or ordered for a person diagnosed with an autism spectrum disorder by a licensed physician or psychologist, including: behavioral health treatment; pharmacy care; and therapeutic care. Treatment may include services such as: evaluation and assessment services; applied behavior analysis; behavior training and behavior management; speech therapy; occupational therapy; physical therapy; or medications or nutritional supplements used to address symptoms of autism spectrum disorder. Therapeutic care means services provided by licensed or certified speech therapists, occupational therapists, or physical therapists. The provisions go into effect on or after July 1, 2011, on such date as a health insurer offers, issues, or renews the health insurance plan, but in no event later than July 1, 2012. Treatment shall be determined by a licensed physician or a licensed psychologist to be medically necessary, and includes: (i) behavioral health treatment, (ii) pharmacy care, (iii) psychiatric care, (iv) psychological care, (v) therapeutic care (which includes services provided by licensed or certified speech therapists, occupational therapists, physical therapists, or clinical social workers), and (vi) applied behavior analysis when provided or supervised by a board certified behavior analyst who shall be licensed by the Board of Medicine. § 38.2-3418.17 As the result of litigation, Washington state Insurance Commissioner, Mike Kreidler, directed all state-regulated private health plans to provide coverage for medically necessary treatment of autism, including coverage of speech, occupational, physical and ABA therapy.Requirements vary state by state for Existing laws in these states are summarized below with a link to each statute. Please be advised that laws, regulations, and policies may change at any time, so always check with your state for the most up-to-date information. Any additional amounts payable to the hearing aid provider shall be paid by the covered individual. Requires insurance companies to offer coverage to employers in the state. 18 § 3357 Requires health benefit policy to provide coverage of up to $3,000 per ear every 48 months for covered individuals 18 years and under. Your support enables the Guttmacher Institute to advance sexual and reproductive health and rights in the United States and globally through our interrelated program of high-quality research, evidence-based advocacy and strategic communications.Colorado, Delaware, Georgia, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Minnesota, Missouri, New Jersey, New Mexico, North Carolina, Oklahoma, Oregon, Tennessee, and Texas require that health benefits plans in their state pay for hearing aids for children. 5/356z.29 (as created by HB 4516 (2018)) Requires health benefit plans to provide coverage for the full cost of one hearing aid per hearing-impaired ear up to $1,400 every 36 months for individuals under 18 years of age as needed, and all related services necessary to assess, select, and fit the hearing aid. The insurer may limit the benefit payable to $1,400 per hearing aid for each hearing-impaired ear every 36 months. § 38 Requires health insurance policies to provide coverage for hearing aids for children up to age 18; coverage may be limited to $1,400 per hearing aid every 36 months. Coverage includes fitting and dispensing services, including providing ear molds as necessary to maintain optimal fit, provided by an audiologist, a hearing aid dispenser or a physician, licensed in New Mexico. Ann.§ 13-7-10; § 59A-22-34.5; § 59A-23-7.8; § 59A-46-38.5; § 59A-47-37.1 Effective January 1, 2011, health plans are required to provide coverage for one hearing aid per hearing-impaired ear up to two thousand five hundred dollars ($2,500) per hearing aid every 36 months for covered individuals under the age of 22 years. Coverage is limited to one hearing aid in each every three years and one cochlear implant in each ear with internal replacement as medically or audiologically necessary.

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Coverage includes, therapeutic care, which is habilitative or nonrestorative, provided by a licensed or certified speech therapist. Coverage includes therapeutic care, which includes services provided by a licensed speech-language pathologist. Treatment covers "therapeutic care" provided by licensed or certified speech therapists, occupational therapists or physical therapists. Coverage provided under this section by an insurer shall be subject to a maximum benefit of $37,080 per year and is not subject to any limits on the number of visits to an autism service provider for treatment of autism spectrum disorders. The benefits will continue until the covered individual reaches the age of fifteen. The benefits and coverage provided must be provided to any eligible person under sixteen years of age. §38-71-280 Requires all individual and group health insurance policies, contracts and certificates issued by health carriers and self-funded nonfederal governmental plans with the exception of the state employee health plan sponsored by the State of South Dakota to provide coverage for treatment of autism spectrum disorder. If an enrollee who is being treated for autism spectrum disorder becomes 10 years of age or older and continues to need treatment, this does not preclude coverage of treatment and services. Treatment includes: (A) behavioral health treatment; (B) pharmacy care; (C) psychiatric care; (D) psychological care; and (E) therapeutic care. Treatment includes: habilitative or rehabilitative care; pharmacy care; psychiatric care; psychological care; and therapeutic care (includes services provided by licensed or certified speech language pathologists, occupational therapists, physical therapists, or social workers), if the physician or psychologist determines the care to be medically necessary. An individual who is being treated and continues to need treatment for autism spectrum disorder and becomes seven years of age or older is not precluded from coverage of treatment and services.

Ann §59A-22-49; §59A-23-7.9; §59A-46-50; §59A-47-45 Requires every policy which provides physician services, medical, major medical or similar comprehensive-type coverage to provide coverage for the screening, diagnosis and treatment of autism spectrum disorder. Isc Law §3216 Requires health benefit plans to provide coverage for the screening, diagnosis, and treatment of autism spectrum disorder. Citation: EHB Benchmark Plan for Ohio [PDF] Requires all plans issued or renewed on or after November 1, 2016, a health benefit plan and the Oklahoma Employees Health Insurance Plan to provide coverage for the screening, diagnosis and treatment of autism spectrum disorder in individuals less than nine (9) years of age, or if an individual is not diagnosed or treated until after three (3) years of age, coverage shall be provided for at least six (6) years, provided that the individual continually and consistently shows sufficient progress and improvement as determined by the health care provider. Rehabilitation services is defined as physical therapy, occupational therapy or speech therapy services to restore or improve function. Treatment includes: pharmacy care, psychiatric care, psychological care, rehabilitative care and therapeutic care (includes services provided by speech language pathologists, occupational therapists or physical therapists) that is medically necessary and prescribed, ordered or provided by a licensed physician, licensed physician assistant, licensed psychologist, licensed clinical social worker or certified registered nurse practitioner. Benefits include coverage for applied behavior analysis, physical therapy, speech therapy and occupational therapy services for the treatment of Autism spectrum disorders. To be eligible for benefits and coverage, an individual must be diagnosed with autistic spectrum disorder at age eight or younger. Codified Laws §58-17 [PDF] (as amended by SB 190 [2015]) Requires a health benefit plan to provide coverage to an enrollee who is diagnosed with autism spectrum disorder from the date of diagnosis until the enrollee completes nine years of age. §1355.015 Effective January 1, 2016, requires a health benefit plan offered or renewed in the individual market or large group market to provide coverage for the treatment of autism spectrum disorder for children 2 to 9 years of age. 57 (2014)] Requires a health insurance plan to provide coverage for the diagnosis and treatment of autism spectrum disorders, including applied behavior analysis supervised by a nationally board-certified behavior analyst, for children, beginning at 18 months of age and continuing until the child reaches age six or enters the first grade, whichever occurs first. 8 § 4088i Requires health insurance plans issued or renewed after January 1, 2012, to provide coverage for the diagnosis and the treatment of autism spectrum disorder in individuals from age two through age six.

§417-E:2 Requires specified health insurance policies and health benefit plans to provide benefits for treatment of autism or other developmental disability. Coverage is "limited to treatment that is prescribed by the insured's treating medical doctor in accordance with a treatment plan." Although behavioral therapy is not specifically defined, the statute does set out a cap of $50,000 per year for coverage of behavioral therapy. Certain insurers may be exempt from requirements for 1 year and may reapply for the exemption yearly. The order also covers new health plan sold through the state healthcare marketplace created under the Affordable Care Act.

§-6ii; Requires specified health insurance policy, health care plan or certificate of health insurance shall provide coverage to an eligible individual who is nineteen years of age or younger, or an eligible individual who is twenty-two years of age or younger and is enrolled in high school, for: Coverage shall be limited to $36,000 annually and shall not exceed $200,000 in total lifetime benefits. Note: Speech language services are not specifically defined in the statute. Treatment means evidence-based care which is prescribed or ordered for a person diagnosed with an autism spectrum disorder by a licensed physician or psychologist, including: behavioral health treatment; pharmacy care; and therapeutic care. Treatment may include services such as: evaluation and assessment services; applied behavior analysis; behavior training and behavior management; speech therapy; occupational therapy; physical therapy; or medications or nutritional supplements used to address symptoms of autism spectrum disorder. Therapeutic care means services provided by licensed or certified speech therapists, occupational therapists, or physical therapists. The provisions go into effect on or after July 1, 2011, on such date as a health insurer offers, issues, or renews the health insurance plan, but in no event later than July 1, 2012. Treatment shall be determined by a licensed physician or a licensed psychologist to be medically necessary, and includes: (i) behavioral health treatment, (ii) pharmacy care, (iii) psychiatric care, (iv) psychological care, (v) therapeutic care (which includes services provided by licensed or certified speech therapists, occupational therapists, physical therapists, or clinical social workers), and (vi) applied behavior analysis when provided or supervised by a board certified behavior analyst who shall be licensed by the Board of Medicine. § 38.2-3418.17 As the result of litigation, Washington state Insurance Commissioner, Mike Kreidler, directed all state-regulated private health plans to provide coverage for medically necessary treatment of autism, including coverage of speech, occupational, physical and ABA therapy.

Requirements vary state by state for Existing laws in these states are summarized below with a link to each statute. Please be advised that laws, regulations, and policies may change at any time, so always check with your state for the most up-to-date information. Any additional amounts payable to the hearing aid provider shall be paid by the covered individual.

,400 per hearing aid every 36 months. Coverage includes fitting and dispensing services, including providing ear molds as necessary to maintain optimal fit, provided by an audiologist, a hearing aid dispenser or a physician, licensed in New Mexico. Ann.§ 13-7-10; § 59A-22-34.5; § 59A-23-7.8; § 59A-46-38.5; § 59A-47-37.1 Effective January 1, 2011, health plans are required to provide coverage for one hearing aid per hearing-impaired ear up to two thousand five hundred dollars (,500) per hearing aid every 36 months for covered individuals under the age of 22 years. Coverage is limited to one hearing aid in each every three years and one cochlear implant in each ear with internal replacement as medically or audiologically necessary.

Coverage must include a new hearing aid every five years, a new hearing aid when alterations to the existing hearing aid cannot meet the needs of the child, and services and supplies such as the initial assessment, fitting, adjustments, and auditory training. As a result of the Affordable Care Act’s prohibition on discriminatory benefit design based on age, the Connecticut Insurance Department is requiring insurance policies to remove age limits on hearing aid benefits for policies issued or renewed after January 1, 2016.

Coverage for treatment of autism spectrum disorders under this section may be limited to a maximum benefit of: Citation: Mont. §33-22-515 Effective July 1, 2014, requires any individual or group sickness and accident insurance policy or subscriber contract delivered, issued for delivery, or renewed in this state and any hospital, medical, or surgical expense-incurred policy, except for policies that provide coverage for a specified disease or other limited-benefit coverage, and (b) any self-funded employee benefit plan to the extent not preempted by federal law, including any such plan provided for employees of the State of Nebraska, to coverage for the screening, diagnosis, and treatment of an autism spectrum disorder in an individual under twenty-one years of age. §44-7,106 Effective January 1, 2011—Requires an individual health benefit plan to provide an option of coverage for screening for and diagnosis of autism spectrum disorders and for treatment of autism spectrum disorders for persons covered by the policy under the age of 18 or, if enrolled in high school, until the person reaches the age of 22. Treatment includes: professional services and treatment programs, including applied behavioral analysis; prescribed pharmaceuticals subject to the same terms and conditions of the policy as other prescribed pharmaceuticals; direct or consultative services provided by a licensed professional including a licensed psychiatrist, licensed advanced practice registered nurse, licensed psychologist, or licensed clinical social worker; and Services provided by a licensed speech therapist, licensed occupational therapist, or licensed physical therapist. Note: Speech language services are not clearly defined in the statue. Code § 5-16B-6e, 33-16-3v, 33-24-7k, 33-25A-8j (as created by HB 2693 [2011]) Requires every disability insurance policy, and every self−insured health plan of the state or a county, city, town, village, or school district, to provide coverage for an insured of treatment for the mental health condition of autism spectrum disorder if the treatment is prescribed by a physician and provided by any of the following who are qualified to provide intensive−level services or nonintensive−level services: a psychiatrist; a psychologist; a social worker; a paraprofessional working under the supervision of a psychiatrist, psychologist or social worker; a professional working under the supervision of an outpatient mental health clinic; a speech−language pathologist; or an occupational therapist.

981 Effective January 1, 2014, requires all health plans issued to a large employer, the state employee group insurance program must provide coverage for the diagnosis, evaluation, multidisciplinary assessment, and medically necessary care of children under 18 with autism spectrum disorders. Children enrolled in medical assistance will receive early intensive intervention for an autism spectrum disorder diagnosis. Treatment for autism spectrum disorders, care prescribed or ordered for an individual diagnosed with an autism spectrum disorder by a licensed physician or licensed psychologist, include: psychiatric care; psychological care; habilitative or rehabilitative care, including applied behavior analysis therapy; therapeutic care (including services provided by licensed speech therapists, occupational therapists, or physical therapists); and pharmacy care. Therapeutic care must be provided by licensed speech-language pathologists. Treatment includes: habilitative or rehabilitative care that is prescribed, provided, or ordered by a licensed physician or licensed psychologist, including but not limited to professional, counseling, and guidance services and treatment programs that are medically necessary to develop and restore, to the maximum extent practicable, the functioning of the covered child; medications prescribed by a physician; psychiatric or psychological care; and therapeutic care that is provided by a speech-language pathologist, audiologist, occupational therapist, or physical therapist licensed in this state. §689A.0435 Requires insurance coverage for diagnosis and treatment of pervasive developmental disorder or autism for all group policies, contracts, and certificates issued or renewed on or after January 1, 2011. Treatment shall be determined to be medically necessary by a licensed physician or licensed psychologist.

§31-3171.01 [PDF] (as amended by Act 20-336 [2013]) Requires health insurance plans to provide coverage to an eligible individual for: Coverage for the services shall be limited to ,000 annually and may not exceed 0,000 in total lifetime benefits for an individual under 18 years of age or an individual 18 years of age or older who is in high school who has been diagnosed as having a developmental disability at 8 years of age or younger. Coverage is "limited to treatment that is prescribed by the insured's treating physician in accordance with a treatment plan." Citation: Ind. §27-8-14.2; §27-13-7-14.7 Requires a group plan established for employees of the state providing for third-party payment or prepayment of health, medical, and surgical coverage benefits shall provide coverage benefits to covered individuals under twenty-one years of age for the diagnostic assessment of autism spectrum disorders and for the treatment of autism spectrum disorders. Effective January 1, 2011, requires insurance coverage for autism.

Coverage includes therapy services provided by a licensed or certified speech therapist or speech-language pathologist. Coverage includes behavioral health treatment, pharmacy care, psychiatric care, psychological care and therapeutic care, including therapy services provided by a licensed speech pathologists. Coverage provided shall be subject to a maximum benefit of ,000 per year, but shall not be subject to any limits on the number of visits to a service provider. Note: Speech language services are not specifically defined in the statute.

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