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The financial cost of autism care can be high, especially for those with intensive needs. Private insurance plans may offset the cost. Understanding if you are covered depends on the type of plan you have and what laws and regulations apply.

It is complicated and can be confusing. Please review the links below. If you have any other questions, call 800.4.AUTISM or email information@autismnj.org.


Types of Plans

Certain therapies for individuals with autism may be covered under their health plan. The types of therapies that are covered and the amount of out of pocket expenses will vary depending on the type of plan covering the individual. 

  • Fully insured plan - Offered by an employer or purchased by individuals in the Health Insurance Marketplace
  • Self-funded plan - Offered by employers (typically large employers)
  • Public health plan - Offered through Medicaid and the Children’s Health Insurance Program (CHIP), and is available to individuals with and without disabilities who meet certain income guidelines

Laws that May Impact Coverage

Other factors that impact coverage are federal and state laws. Not all laws apply to all types of plans. The most important laws affecting health coverage for people with autism are:


Implementation Concerns

Just because there are laws in place, there still may be obstacles to accessing coverage. 


Autism New Jersey Public Policy

Learn more about our steadfast advocacy work in Trenton and our partnership with the legislature, state officials, industry officials, families and providers.  We remain committed to improving access to quality, evidenced-based treatment for individuals with autism and to help lessen the financial burden on families.  


Additional Resources

Click here for additional resources



Health Insurance & Autism:
What to Expect

Free Webinar for Parents & Professionals

September 22, 2016 • 2:00pm

Many New Jersey families seeking coverage of autism treatment find that their health plan does not include coverage of services such as Applied Behavior Analysis (ABA). Other families planning to purchase coverage through the health insurance marketplace may have questions about their options. Register for this free webinar>>

 

Health Insurance News/Updates

Federal Employees Health Benefits (FEHB) Program to Include Coverage of Applied Behavior Analysis in 2017

March 2, 2016

Autism New Jersey is pleased to announce that health insurance coverage of Applied Behavior Analysis (ABA) will soon be available to even more families.

The U.S. Office of Personnel Management (OPM) recruits and maintains the Federal workforce of about 8 million civilian employees, and is responsible for providing health insurance benefits to Federal employees. Learn more>>

AUTISM NEW JERSEY
500 Horizon Drive, Suite 530 Robbinsville, NJ 08691
Phone: 609.588.8200; 800.4.AUTISM | Fax: 609.588.8858
Email: information@autismnj.org

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