Problems with being diagnosed with autism

It’s very upsetting to be told that your child has an autism spectrum disorder.  Most parents will tell you it’s one of the worst days of their lives. After lengthy interviews and exams there's a conference to tell you the diagnosis of autism.  After that the family or individual is on their own to find needed services.  This site lists a few useful resources for those with a new diagnosis of autism.

In addition, an autism diagnosis is a preexisting condition that will prevent your child from buying individual health insurance. Arkansas is a state with medical underwriting, where insurance companies can get records of your health before setting premiums or allowing any coverage at all. An adult with an autism diagnosis cannot get past medical underwriting, but starting in 2011 the Obama healthcare changes require that all children be accepted into private insurance pools. Adults will all be accepted in 2014. However, insurance can still charge a higher rate based on your pre-existing condition.

In fall 2011 Arkansas has started a private insurance mandate for autism therapy coverage. The mandate only applies to non-ERISA insurance, the teachers' insurance pool, and the state employees' pool. That person can, however, enroll in group medical coverage or medicaid programs.

Any time a doctor or therapist lists “autism” as the medical cause on the billing form, your claims will often be denied unless you are in one of the private insurance mandate groups. After an autism diagnosis, many patients must constantly refile claims. Even getting an autism diagnosis is rarely covered by insurance. Autism is excluded from medical insurance coverage, although you can receive treatment for many of the conditions around autism: ADHD, anxiety, fine motor skill delays, etc.

An autism diagnosis in many ways gives you a general picture of your child’s difficulties, but new frustrations appear soon. The worst frustration is that while there’s the generally accepted autism treatment method, ABA therapy, there is almost no funding for the expensive treatment. It’s like looking at Thanksgiving dinner through the plate glass window. You may be hungry, you need food, but you’re not getting any. Currently the intensive autism therapies are out of reach for most Arkansas families. The new private insurance mandate will provide ABA services for non-ERISA private plans, state employees, and teachers insurance pools.

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