[Note: Shared for #AutisticHistory archive purposes. This is NOT An Autistic Ally.]
Autism Insurance? There’s Now An App For That
November 11, 2013
NEW YORK (November 11, 2013) — In response to widespread confusion over autism and insurance coverage, Autism Speaks is introducing a new interactive web tool to help families determine whether they should be entitled to coverage through their specific health plan.
Called the Autism Speaks Insurance Link, the new tool leads families through a short series of questions to determine whether their policy covers common autism treatments, such as applied behavior analysis (ABA), and physical, speech and occupational therapy. The application was developed over a period of months and addresses the multiple forms of insurance coverage available to the autism community.
“Understanding basic insurance coverage does not lend itself to simple ‘yes’ or ‘no’ answers. Throw in coverage for autism benefits and the picture grows more confused,” said Lorri Unumb, Autism Speaks executive vice president for state government affairs.
“Families in the autism community have long asked us to help lead them out of this maze,” she said. “We believe the Autism Speaks Insurance Link will help answer many questions for our families.”
Until recently, such benefits have been largely unavailable through any health insurance coverage because insurers deemed autism a diagnostic exclusion and denied coverage for ABA and other therapies.
Due in large part to the efforts of the Autism Speaks’ Advocacy Team, 34 states and the District of Columbia now have laws on the books requiring coverage of ABA and other autism benefits in state-regulated health plans. These include some combination of individual and fully funded small group (fewer than 50 employees), large group and state employee health plans.
In addition, Autism Speaks has helped fight for changes in Congress to TRICARE, the health care plan for the military, and with the Office of Personnel Management for changes to the Federal Employees Health Benefits program.
But self-funded “ERISA” health plans, typically offered by larger employees, are governed by federal law and are not required to offer any autism-related coverage. Autism Speaks has worked with many large employers to voluntarily offer autism benefits, but there is no legal requirement.
In addition, some state laws set dollar or age caps on benefits, and military families and federal civilian employees face significant gaps in their coverage.
The Autism Speaks Insurance Link helps families sort through the various types of insurance, restrictions and caps to determine if they are entitled to benefits. lf entitled to coverage, the tool will provide details of the coverage required by state law along with resources to assist in claims reimbursement.
If coverage is not available, such as under an ERISA plan, the Insurance Link will equip families with tools to effectively advocate for the addition of a meaningful benefit.
The new Insurance Link follows the release of our web resources for the Affordable Care Act and Autism.
Autism Speaks Insurance Link
Navigating the complexities of health insurance can be very challenging – especially when trying to determine your coverage for autism. “Autism Speaks Insurance Link” is an online application developed by Autism Speaks that will help you determine whether an individual is entitled to coverage for the treatment of autism under their health insurance plan. Based on your responses, this tool will provide details of the coverage required by state law and resources to assist in claims reimbursement. If coverage is not available under the existing plan, “Autism Speaks Insurance Link” will equip you with information necessary to effectively advocate for the addition of a meaningful benefit.
Please note: Responses to questions are not stored on our website and no information that could identify the patient is requested.
Autism Speaks’ has worked to pass meaningful autism insurance reform across the country. More than 40 states have now enacted laws that require certain health insurance plans to cover the treatment of autism. These states appear in green on our state initiatives map. Unfortunately, determining whether your insurance plan includes a meaningful autism benefit is not as easy as looking at a map. Not all plan types are subject to state law. Additionally, many state autism insurance laws further exclude certain plan types or impose age caps that may adversely affect your coverage.
Before you begin
In order to provide you with the most accurate information, you will be asked a short series of questions (6 at most) about the patient’s health insurance plan. While you should be able to answer most of these questions very easily, others are technical in nature and may require you to gather a little information. It may be helpful to have the following items available for reference:
- A copy of the patient’s health insurance card;
- The patient’s detailed Summary Plan Description, or “SPD” (SPDs are generally provided by your Human Resources Department at the time of enrollment in an employer-sponsored health benefit plan); and
- Contact information for the primary insured’s Human Resources Department
If you cannot find the answers on the insurance card or SPD, you may need to contact the Human Resources Department. For your convenience you may want to print out a copy of the questions before you call so you can get all of your questions answered at once. After you have gathered the information, simply enter the responses in “Autism Speaks Insurance Link.”
The Autism Community Is Not The Autistic Community
Autistic people have fought the inclusion of ABA in therapy for us since before Autism Speaks, and other non-Autistic-led autism organizations, started lobbying legislation to get it covered by insurances and Medicaid.
ABA is a myth originally sold to parents that it would keep their Autistic child out of an institution. Today, parents are told that with early intervention therapy their child will either be less Autistic or no longer Autistic by elementary school, and can be mainstreamed in typical education classes. ABA is very expensive to pay out of pocket. Essentially, Autism Speaks has justified the big price tag up front will offset the overall burden on resources for an Autistic’s lifetime. The recommendation for this therapy is 40 hours a week for children and toddlers.
The original study that showed the success rate of ABA to be at 50% has never been replicated. In fact, the study of ABA by United States Department of Defense was denounced as a failure. Not just once, but multiple times. Simply stated: ABA doesn’t work. In study after repeated study: ABA (conversion therapy) doesn’t work.
What more recent studies do show: Autistics who experienced ABA therapy are at high risk to develop PTSD and other lifelong trauma-related conditions. Historically, the autism organizations promoting ABA as a cure or solution have silenced Autistic advocates’ opposition. ABA is also known as gay conversion therapy.
The ‘cure’ for Autistics not born yet is the prevention of birth.
The ‘cure’ is a choice to terminate a pregnancy based on ‘autism risk.’ The cure is abortion. This is the same ‘cure’ society has for Down Syndrome.
This is eugenics 2021. Instead of killing Autistics and disabled children in gas chambers or ‘mercy killings’ like in Aktion T4, it’ll happen at the doctor’s office, quietly, one Autistic baby at a time. Different approaches yes, but still eugenics and the extinction of an entire minority group of people.
Fact: You can’t cure Autistics from being Autistic.
Fact: You can’t recover an Autistic from being Autistic.
Fact: You can groom an Autistic to mask and hide their traits. Somewhat. … however, this comes at the expense of the Autistic child, promotes Autistic Burnout (this should not be confused with typical burnout, Autistic Burnout can kill Autistics), and places the Autistic child at high risk for PTSD and other lifelong trauma-related conditions.
[Note: Autism is NOT a disease, but a neurodevelopmental difference and disability.]
Fact: Vaccines Do Not Cause Autism.