Arizona Autism Insurance Bill (Steven's Law)

Steven's Law / Insurance Implementation Facts, based on the written law:

You can find out if your insurance company offers this coverage and if you are eligible for this coverage by calling your insurance company and asking about the benefits for autism coverage and those benefits effective date.

Purpose: Requires certain health insurers/carriers to provide coverage for the diagnosis and treatment of behavioral therapy services for Autism Spectrum Disorder -also know as ASD, including the diagnosis of: Autism, Asperger's Syndrome and Pervasive Developmental Disorder not otherwise specified - also know as PDD-NOS.

Effective Date of the law: July 1, 2009.

Eligibility Information: Children ages 0-9 can receive up to a maximum of $50,000.00 per year of insurance benefits, children 10-16 can receive up to a maximum of $25,000.00 per year of insurance benefits. Services are not subject to any limits on the number of visits per year.

Coverage: The covered benefits are behavioral therapy, psychiatric care and psychological care. For purposes of this law - "Behavioral Therapy" includes interactive therapies derived from evidence based research including Applied Behavior Analysis (ABA) also known as Lovaas, discrete trial, pivotal response trainings, intensive intervention and early intensive behavioral intervention.

Treatment Plan Requirements: Treatment plan's must include Diagnosis, treatment type, frequency and duration of treatment, anticipated outcomes/goals, frequency of treatment plan updates and treating medical doctors signature. The insurer (insurance company) can request an updated treatment plan every 6 months unless agreed upon due to emerging clinical circumstances.

Exemptions (companies, individuals not required to offer Autism coverage):

Small businesses-employers with 50 or less employees. Limited Benefit coverage (policies designed to supplement major medical policies). Self Insured plans (typically larger companies who pay for their own claims). Plans underwritten in states other than Arizona are also exempt.