In North Carolina alone, one in 58 children fall somewhere on the autism spectrum, according to the Center for Disease Control (CDC). Starting next year, many of those children will now have better access to health care through their insurance providers.
Governor Pat McCrory signed a bill in Charlotte on Thursday, October 15 that will require most insurance plans to cover certain treatments for autism. This is good news for families affected by autism, as well as autism advocates in the community.
North Carolina is the 43rd state to make insurance coverage for autistic children the law of the land. South Carolina was one of the first to adopt a similar law back in 2007.
The new regulations will expand coverage for treatment considered to be medically necessary. This includes speech therapy, occupational therapy, physical therapy, pharmacy care, and psychiatric and psychological care. Coverage will be capped at $40,000 a year and will continue for children through their 18th birthday.
The new law goes into effect July 1, 2016 and will apply to new plans or renewing plans on or after that date. The changes will affect large group plans, grandfathered plans – individual and small business plans in effect and unchanged since March 2010, and grandmothered plans – individual and small business plans that aren’t grandfathered in but were in effect prior to 2014. There are some exemptions including companies who have self-funded insurance. Those companies may opt-in but are not required to do so.
Parents of autistic children around North Carolina will be able to breathe a little easier knowing their children will be able to receive therapy and care they desperately need. Less money coming out of their pocket and less time spent trying to provide the care themselves will help not only the thousands of children affected by this law, but their parents and families as well. This law removes a barrier for some children and provides relief to their families. It’s good news for families and communities across North Carolina.
Whether you’re a small business offering insurance to your employees or a family with an individual plan, Charlotte Insurance can help you understand how this law will affect your health insurance. Give us a call – we’re here to help.
Image courtesy of Flickr user Becky Wetherington.