The American Academy of Pediatrics offers guidance regarding early screening for developmental delays as well as specific screenings for risk of autism.
There are two primary vehicles that guide the types of autism-related coverage that insurers provide: 1) state “autism insurance mandate” legislation, and 2) services the federal government and states mandate through public health insurance programs.
State: Autism insurance mandates
Most states have enacted autism insurance reform laws that require insurance carriers to provide coverage for autism treatment. But certain insurance plans are exempt from state mandates. Please contact your plan administrator to see if your plan includes state mandated autism spectrum disorder benefits.
Public health insurance
- Medicaid: Medicaid is a federal and state funded program that helps cover healthcare costs for some people with limited income and resources. The Medicaid program covers 1 in 5 Americans including many with complex and expensive healthcare needs. The program is the main source of long-term care coverage for Americans when other insurance options cost too much, and it covers a variety of health services, limiting people’s out-of-pocket costs.
- Medicare: Medicare is a federal insurance program for this country’s aging population, specifically people age 65 or older. Like Medicaid, the program helps with the cost of health care, but it does not cover all medical expenses or the cost of most long-term care.
- Dual eligibility: People who qualify as dual eligible are individuals who receive both Medicare and Medicaid benefits. The two programs cover many of the same healthcare services, but Medicare pays first for the Medicare-covered services that are also covered by Medicaid. Medicaid covers services that Medicare does not cover.
Autistic adults, and adults with intellectual disability live with multiple risk factors for infection with COVID-19 and for experiencing more severe disease if they contract COVID-19. Identifying these risk factors for COVID-19 among autistic adults, and adults with intellectual disability is important for prioritizing public health initiatives and standards of care – including vaccination, testing, masking and distancing. Additionally, awareness of risks can help with decision-making in caring for these populations.