Dan Unumb – Insurance Coverage for All

1.0 Type II CE Credit

This presentation was recorded at the 2014 CCBS West Coast Conference on Autism.

About the presentation:

In 2004, the New York Times wrote that “no disability claims more parental time and energy than autism.” Families dealing with autism face many hardships, not the least of which is financial hardship. One reason for the financial hardship is the failure of the health insurance industry to cover treatments for, and sometimes even diagnosis of, autism. Access to health insurance for individuals with autism has been limited in two primary ways:

(1) insurance was altogether unattainable, as insurers simply refused to write a policy on an individual or family member with autism, or

(2) individuals could obtain a policy, but the policy failed to cover the treatments being prescribed, particularly interventions using ABA methodology.

Recently, there has been a national movement toward legislating meaningful health insurance coverage for individuals with autism. Since 2007, more than 30 states have enacted legislation requiring meaningful coverage for autism spectrum disorders. In this session, we will explore the reasons autism treatments have historically not been covered by health insurance and discuss arguments to refute those reasons. We will examine the language of the new autism insurance laws, including a comparison of their key terms and features. We will learn about the different types of public and private health insurance plans and discuss pitfalls that providers and consumers should watch out for when attempting to utilize benefits. We will talk about strategies for approaching self-funded employers (who are not subject to the new state laws) regarding voluntary implementation of autism benefits. Finally, we will discuss the intersection of various funding streams for autism interventions and examine who should pay for what and when.

Learning Objectives:

• Participants will state at least 3 reasons health insurance has typically denied coverage for Applied Behavior Analysis interventions.
• Participants will state the key terms and features of a typical autism insurance mandate.
• Participants will identify at least 5 different types of healthcare coverage.