Oklahoma Autism Insurance Reform Summary

by | May 8, 2016

Effective Novemeber 1, 2016 upon plan year renewal

Requires coverage for the screening, diagnosis and treatment of autism spectrum disorder when prescribed by a licensed physician or psychologist who determines the care to be medically necessary.

 

Treatment Includes

  • Behavioral health treatment, including applied behavior analysis up to $25,000 annually
  • Psychiatric, psychological and pharmacy care
  • Speech, occupational and physical thearapy

HB2962 includes various treatment caps, explained below.

 

If you…

Were diagnosed before the age of three.

Coverage includes treatment up to age nine.

Were diagnosed after the age of three.

Coverage includes at least 6 years of treatment.

Accessed treatment before the age of three.

Coverage includes treatment up to age nine.

Accessed treatment after the age of three.

Coverage includes at least six years of treatment.

Never previously accessed treatment.

Coverage includes at least six years of treatment.

The law does not affect any obligation to provide services to an individual under an individualized family service plan, an individualized education program or an individualized service plan.

Coverage requirement applies to:

  • State Employee Health Plan
  • Oklahoma State Regulated Health Plans
    (excluding non-grandfathered plans in the individual and small group market aka Obamacare plans)

Contact Judith Ursitti at judith.ursitti@autismspeaks.org if you have any questions.