Posts Tagged - ‘autism’

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Health Insurance Plans’ Autism Coverage Under Fire

Tuesday, September 28th, 2010

Image: Bob Bobster under CC 3.0

Republicans running for Congress this year are touting their anti-Obamacare credentials. Nevada’s Sharron Angle is no different. Boosted by the tea party past a more moderate candidate in the GOP primary, she is going up against Senate Majority Leader Harry Reid in November. As one of the key architects behind the controversial healthcare reform law, Reid is in danger of losing his seat.

Angle is obviously against the individual coverage mandate, as well as health insurance plans being forced to cover certain conditions. She blames the latter for raising costs. Video from a speech last year on that issue has recently been released to controversy. In that speech, Angle railed against a state law that requires health insurers to cover early treatment for autism spectrum disorders. When she mentioned the word “autism”, she used air quotes, which some have interpreted as meaning that she doesn’t believe that autism is a legitimate condition that children’s health insurance should treat.

Not done offending people, Angle went on to say that maternity coverage should not be mandated, since she herself is done having children.

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Missouri Health Insurance Must Now Cover Autism

Friday, June 11th, 2010

Image: jeffk under CC 3.0

The governor of Missouri, Jay Nixon, recently signed legislation that mandates family health insurance coverage for autism treatment.

What does the bill do?

  • It requires that all Missouri health insurance companies cover the screening, diagnosis and treatment of autism spectrum disorders.
  • Insurers are now also mandated to provide up to $40,000 worth of Applied Behavioral Therapy (ABA), which has been clinically shown to be effective in many cases, until the child turns 18.
  • Meanwhile, small businesses who can prove that the law will increase their premiums by 2.5% are exempt.

Despite that, some are worried that the new requirements will drive up costs, pricing many others out of the market and leaving them uninsured.

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Autism Babies Linked to Older Moms

Tuesday, February 9th, 2010

Researchers have made new discoveries about what is causing some children to develop autism. A new study found mothers older than 40 were about 50 per cent or 1.51 times more likely to have a child with autism than mothers aged 25 to 29; the risk for fathers older than 40 was 36 per cent higher than for men in their late 20s. Although the fathers age can be a contributing factor a mothers age is far more relevant.

Researchers have been perplexed with autism for some time now. Some scientists have linked the disorder to different factors including child vaccinations, environmental toxins, heredity and genetics. However, they have not found any single cause for autism. Even mothers with adequate medical insurance can find themselves in this position.

According to the Autism Society, autism is a pervasive development disorder that affects between 1 in 100 and 1 in 110 children in the US. It starts before the age of 3 and is characterized by repetitive and restricted behaviors and deficiency in social skills and communication and is thought to be linked to abnormal brain development that probably starts in the womb.

Researchers still need to figure out what it is about older parents that puts their children at greater risk for autism and other adverse outcomes, so they can we can begin helping those mothers who are at risk. In the meantime, health professional suggest mothers said it’s important to note that the increased risks are small and that most babies born to older mothers do not develop autism.

Researchers said the overall low risk for autism “may be the most important take-home message especially for prospective parents. However, expecting mothers who have health insurance get better care during their pregnancy, and have a much better chance of delivering a healthy baby. It is essential that all expecting mothers have adequate access to doctors for health advice and care.

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FAQ: Finding Affordable Health Insurance For Autistic Children

Friday, January 22nd, 2010

If your child is autistic, you are no doubt familiar with the financial and health challenges involved. Unfortunately, many health insurance policies do not cover treatments for what has become a more prevalent condition. Doctor visits, prescriptions, speech and occupational therapy all add to the cost involved: anywhere from $67,000 to $72,000 per year, depending on where the child is on the autism spectrum.

Here are some answers to questions you may have when you are struggling with this family health insurance issue.

Q: Does my state mandate health insurance coverage for autism?
The following states currently require all health insurance sold within their borders to offer autism-related coverage, which is a start:

  • Arizona
  • Colorado
  • Connecticut
  • Florida
  • Illinois
  • Indiana
  • Louisiana
  • Montana
  • Nevada
  • New Jersey
  • New Mexico
  • Pennsylvania
  • South Carolina
  • Texas
  • Wisconsin
  • New Hampshire and Maine also have pending legislation. Remember that the specific types and level of coverage vary among states.

    Q: What if my state doesn’t require health insurance plans to cover autism-related treatments?
    An increasing number of large employers include autism coverage in their plans. Failing that, it is possible to buy family health insurance on the open market–although in some cases, it may be more affordable to buy a specific individual health insurance plan for your child. It is essential to shop around for the right plan, which will provide for the care your child needs.

    Q: What should I think about when buying health insurance for my autistic child or children?
    The needs of the child should come first, just like they should for non-autistic children. You must think about the recommended treatments for your child and the cost of those treatments. Many health insurance options cover autism, but have annual or lifetime limits on the amount that can be spent. Behavioral therapy and other techniques are often expensive, eating through a $36,000 yearly cap surprisingly quickly. A nonverbal child will probably require a more comprehensive policy than a child with a milder form of autism. Some health plans may also limit the number of times per year a child can visit a particular type of therapy session. Also keep in mind that certain medical conditions, such as gastrointentional problems, are more common; therefore, it is important to make sure those are covered.

    Q: How can I make sure that my health insurance company doesn’t deny my child’s claim?
    Health insurance companies have certain protocol and procedures they depend on when deciding whether to approve or deny a medical claim. These procedures are often based on years of scientific studies based on the average population. Individualized treatment is often necessary with autistic children, leaving it to parents to argue in favor of a particular course of action. It is best to pick a plan with a positive reputation and good customer service, and come armed with research and expert referrals.

    Q: What if I can’t afford to pay for my child’s autism treatments?
    There are several options available, including financial subsidies from private organizations like United Healthcare, as well as Medicaid. While the waiting list is long, the program for poor residents will accept children with a sufficiently severe form of autism, regardless of their family’s income. In addition to such waivers, you can bargain with teachers and other caregivers to stretch your healthcare dollars. For example, instead of using your health insurance to duplicate treatment your child is already receiving at school or elsewhere, use it to supplement existing therapy.

    (Image Beverly & Pack under CC 2.0)

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