Autism insurance in california

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Background: On July 1st, 2012, the Autism Insurance Law (SB946 Steinberg) signed by California Governor Jerry Brown went into effect requiring health plans governed by California, to include coverage for autism as a medical benefit. 

This law affects California regulated plans (also known as fully funded or fully insured plans) fall under the guidance of the new Autism Health Insurance Law.  As of August 27, 2012, the Department of Managed Health issues a draft emergency regulation saying that Healthy Families and CalPERS funded plans are covered under this new law.  

ASC FAQ Handout on the California Autism Insurance Law.

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Please learn the latest about autism health insurance in California at the Autism Health Insurance Project: http://www.autismhealthinsurance.org/
Autism Society of California Insurance Surveys and Reports
Impact of California’s Autism Insurance Legislation – 2014 Survey

Executive Summary Impact of California’s Autism Insurance Mandate Coverage Legislation- Revised March 2014

2013 ASC California Autism Insurance Law Survey Highlights
Click here for the full report
Findings include:
  • 60% of families with California regulated plans tried to obtain ABA services. However, only 32% were approved.
  • 63% of families with federally regulated  plans tried to obtain services, with 28% approved.
  • For families with a California regulated plan, 42% of them reported a delay in starting services; 40% financial hardship from co-pays, 36% with deductibles and 26% with coinsurance; and 36% reported a lack of providers. 
  • Delay in starting: 65% of families with California regulated plans indicated that insurance plans took more than 61 days to provide ABA services, even though California law requires health plans to provide timely access to care.