Insurance

Will my insurance cover services for my child?

If your child has a diagnosis of an autism spectrum disorder, you will want to check to see if your insurance will cover services under the Florida Mandate. There are specific criteria for insurance qualifications. You can learn more about what insurance will and will not cover at these helpful sites:
http://www.centerforautism.com/Data/sites/1/media/national-funding-overview.pdf
http://www.autism-society.org
http://www.autismvotes.org/site
http://www.tacanow.org/family-resources/autism-insurance-resources
http://www.autismspeaks.org/images/advocacy/FL

To read State Bill 2654, go to http://archive.flsenate.gov.

Contact your Human Resources Department and find out what benefits are covered under your health plan. Many caregivers report that their call is passed on to numerous people before they get answers about their insurance coverage. Be sure to document your phone calls and know who you are speaking with. You can request to be assigned to a “case manager” who may be your primary contact.

Your insurance will likely require 1) a prescription from the child’s Primary Care Physician (PCP), 2) a letter stating the medical necessity of services, and 3) a documented diagnosis by a medical professional. The prescription should specify the type of service(s) that are being recommended and the frequency of services per week.

Even if your insurance does not have benefits for a specific service (i.e. behavioral services), your child may be eligible on the basis of “medical necessity.” Be sure to do your research.