Source: https://www.cga.ct.gov/2006/rpt/2006-R-0793.htm
Timestamp: 2017-08-17 11:30:35
Document Index: 320216105

Matched Legal Cases: ['§ 17', '§ 38', '§ 33', '§ 27', '§ 304', '§ 3221']

MENTAL HEALTH; HEALTH INSURANCE; AUTISM; MEDICAL CARE;
INSURANCE - HEALTH; MEDICAL CARE;
2006-R-0793
Insurance Department staff declined to comment on the extent of coverage required for autism due to their lack of medical expertise. They did note that many policies exclude custodial services, some of which are covered through the Department of Mental Retardation as part of the Birth to Three program (see CGS §§ 17a-248 through 17a-248g). Policies must provide coverage for medically necessary early intervention services provided as part of an individualized family service plan. Policies must provide (1) coverage for such services provided by qualified personnel for a child from birth until the child's third birthday, and (2) a maximum benefit of $3,200 per child per year and an aggregate benefit of $9,600 per child over the total three-year period (CGS §§ 38a-490a and 38a-516a).
Georgia. If a policy includes benefits for neurological disorders, it is prohibited from denying benefits for autism. Such benefits are subject to the same terms and conditions as those for neurological disorders (Ga. Code Ann. § 33-24-59.10).
Indiana. Policies must include coverage for pervasive developmental disorders, including autism. Coverage may not be subject to dollar limits, deductibles, copayments, or coinsurance provisions that are less favorable to an insured than those that apply to physical illness. Insurers and HMOs cannot deny or refuse to issue coverage on, refuse to contract with, refuse to renew or reissue, or otherwise terminate or restrict coverage on an individual because of a pervasive developmental disorder diagnosis (Ind. Code §§ 27-13-7-14.7 and 27-8-14.2-1 through 27-8-14.2-5).
Kentucky. Health benefit plans must include coverage, including therapeutic, respite, and rehabilitative care, for the treatment of autism for a child age 2 through 21. Coverage is subject to a maximum benefit of $500 a month for each covered child (Ky. Rev. Stat. Ann. § 304.17A-143).
New York. Policies are prohibited from excluding coverage for the diagnosis and treatment of ASD, including autism (N.Y. Ins. Law § 3221(l)(17), effective January 1, 2007).