Skip to content

Need to talk? Call or text 988 (US)

RecurrentDepression

Many Medical insurance Plans Do Not Cover Treatment For Autism

David Mazoor, M.D.Published March 22, 20104 min read

Key points

  • Case studies have revealed that children with autism receiving therapy at the onset of symptoms can experience higher IQ levels as well as better behavior and language skills.
  • Studies show that treating children with autism as early as possible can cut costs for care and education by half and helps to provide for a brighter and more productive future for the children.
  • Governor of Missouri Jay Nixon lists insurance mandates for autism treatment coverage as a high priority on the list of topics for the 2010 legislative session.
  • As legislation moves forward, advocates for families are striving to ensure the mandates will not be restrained by insurance company caps or exemptions.

Case studies have revealed that children with autism receiving therapy at the onset of symptoms can experience higher IQ levels as well as better behavior and language skills. Although these therapies have shown to improve the quality of life of children with autism and their families, certain Missouri and Kansas insurance companies are not currently providing coverage for such treatment. Because the therapies can cost families up to $70,000 each year, most are unable to afford the treatments available to their children without assistance.

However, a closer look at the cost of treating children with autism shows that by providing coverage for these highly successful therapies, the states may save significant money in the long run. For example, a person with a severe case of autism who requires state assistance for education and adult specialized care can cost governmental programs three to four million dollars over the course of their lifetime if parents are unable to pay.

Studies show that treating children with autism as early as possible can cut costs for care and education by half and helps to provide for a brighter and more productive future for the children.

Activists are calling out the states of Missouri and Kansas, asking them to join the list of states that are already mandating medical insurance providers to cover the costs for behavioral therapy for autism.

Politicians are beginning to respond to the call. Governor of Missouri Jay Nixon lists insurance mandates for autism treatment coverage as a high priority on the list of topics for the 2010 legislative session.

Republicans and Democrats alike are supporting the idea. In fact, Republican Representative Jeff Grisamore is a co-sponsor of a related bill in the House of Representatives. He believes putting an insurance mandate in place is not only in the best interest of families facing autism but also a good financial decision for the state of Missouri.

As legislation moves forward, advocates for families are striving to ensure the mandates will not be restrained by insurance company caps or exemptions. Although Missouri seems to be well on its way to seeing positive change regarding coverage for autism therapies, in Kansas the legislation experienced a stall in 2009.

Kansas families and advocates have worked for two years to see necessary mandates go through legislation. However, some lawmakers are concerned that these mandates would lead to increased medical insurance premiums across the board in Kansas, although this problem has not happened in other states that have passed the insurance mandates.

The first states to begin passing mandates for coverage for autism therapies saw premiums increase around $1 each month. Considering more than 4,000 families are currently on the Kansas waiting list for services, the need requires change in medical insurance plans in order to better serve those families.

A reported 15% of people receiving services in Kansas have autism-related issues. If Kansas insurers pay for treatments, it would relieve the state to be able to provide more help for people with other disabilities.

Current statistics show that one out of 110 children is affected by autism-which is identified as a disorder affecting language, relationship skills and concentration. Severe autism leaves individuals struggling to function as independent adults without proper treatment. Scientists have not yet identified a specific cause for autism and why it is continuing to increase.

A specialist with Children’s Mercy Hospital in Kansas City explains that early intervention is the key for a positive outcome for children with autism. If Kansas and Missouri join the states that are currently giving necessary attention to the autism crisis, many families will benefit and the state will save money in the long run.

For more information about Autism and how you can help please visit, the National Autism Association

National Autism Association
nationalautismassociation.org

Revised and edited by

David Mazoor, M.D.

Medically reviewedLast reviewed

The content on this site is for information only and is not a substitute for professional medical advice, diagnosis or treatment. If you are in crisis, call or text 988 (US) or your local emergency number.

If you need help now

Reaching out is a sign of strength.

If you are thinking about suicide or worried about someone, talk to someone today. In an emergency, call your local emergency number.