Insurance Coverage for Autism Therapy in Colorado

Colorado Division of Insurance, Colorado, Texas – There is a gap in insurance coverage for children with autism. KOAA 5 News report that the Division of Insurance adopted new policies following changes to the Affordable Care Act that eliminated lifetime caps for treatment. Parents have since reported that this change has dramatically reduced the amount of autism therapy covered by insurance companies.

Maddie Garrett reporting for KOAA states that:

‘The Division of Insurance made an emergency regulation that states insurance companies must go back to covering the same amount of autism treatment they did in health plans issued prior to May 2013. It’s meant to bring back up the amount of therapy children were used to getting’

Dawn Zinc, Assistant Therapeutic Director at Play Date Behavioral Interventions told KOAA that if these children lose their Applied Behavioural Analysis (ABA) therapy then they could regress.

After the Division of Insurance changed the cap, children are now only receiving 6 – 18 months of treatment a month, which they used to receive in a week.

When parents and autism organisations objected to these changes the Division of Insurance made a change.

A temporary rule is now in place which tells insurance companies to go back to the plans from a year ago.

Dawn Zinc is reported as saying that most insurance companies have gone back to the old plans and are covering more therapy, however Kaiser Permanent has not.

“Parents are… trying to get this insurance company to return their calls and it’s just not happening and our thought is that’s the way they want it to be. But we’re not going to accept it, we’re going to keep fighting to keep these kids in therapy,”

KOAA 5 News report that:

‘The emergency regulation is in place for the next 120 days. During that time, the Division of Insurance said it will hold additional public hearings and conduct more studies on how much therapy should be covered.’

DORA Communications Manager Vincent Plymell suggested in the article that any parents having issues with their insurance should report it to the Division of Insurance.

The article by Maddie Garrett in KOAA 5 News can be read here