What Autism Benefits are Mandated by Arizona State Law?
Under Arizona state law, specific mandates are in place to ensure that certain health insurance plans provide coverage for the diagnosis and treatment of autism spectrum disorder.
Key benefits mandated by Arizona law include:
- Applied Behavior Analysis (ABA) Therapy: The law specifically requires coverage for ABA therapy, which is an evidence-based treatment for autism.
- Coverage Age Limit: Arizona’s mandate requires coverage for eligible individuals up to age 16.
- Diagnosis and Treatment Planning: Covered services include diagnostic assessments and the development of formal treatment plans.
- Historical Context: This mandate was enacted in 2008 to prevent insurance companies from excluding autism treatments as experimental or not medically necessary.
It is important to note that these state mandates typically apply to state-regulated (fully insured) plans. Self-funded ERISA plans, often provided by large employers, are regulated by federal law and may not be subject to these state-specific requirements. Additionally, insurers in Arizona may still require documentation of medical necessity from a doctor or psychologist to authorize these benefits.
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