Monarch Center for Autism Cleveland Ohio

Medical Insurance

Most states do not require private insurance companies to cover even essential autism treatments and services. In the absence of coverage, families often pay as much as they can out-of-pocket for services that can cost upwards of $50,000 per year. In the process, many risk their homes and the educations of their unaffected children – essentially mortgaging their entire futures. Autism Speaks, together with other autism advocacy groups, is working to change state insurance laws to require private health insurance policies to cover the diagnosis and treatment of autism spectrum disorders for individuals under the age of 21.

The insurance legislation supported by Autism Speaks specifically targets coverage of Applied Behavior Analysis (ABA) and other structured behavioral therapies, which are the most effective forms of treatment and have the best outcomes, both in human costs and in long-term economic benefits. Nationwide, few private insurance companies or other employee benefit plans cover Applied Behavior Analysis and other behavioral therapies. In fact, most insurance companies designate autism as a diagnostic exclusion, meaning that no autism-specific services are covered, even those that would be used to treat other conditions.

Autism Speaks has outlined eight arguments in support of private insurance coverage of autism-related services – based on importance, efficacy, and costs associated with autism insurance coverage -- in the document Arguments in Support of Private Insurance Coverage of Autism-Related Services. It can be found by clicking here258


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