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Real members of MyAutismTeam have posted questions and answers that support our community guidelines, and should not be taken as medical advice. Looking for the latest medically reviewed content by doctors and experts? Visit our resource section.

My Employer-provided Insurance Excludes Mental Health Services For Autism. Any Tips On How Get Some Counselling?

A MyAutismTeam Member asked a question 💭
Urbandale, IA
July 28, 2012
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A MyAutismTeam Member

I would apply for SSI. One of the benefits is health insurance. Our private insurance doesn't pay for my son's therapies but his medicaid does (which is a godsend)

July 29, 2012
A MyAutismTeam Member

When you say "employer-provided" is that self-insured?
If it is not- you can pursue through Department of Managed Health Care by filing a grievance with your insurance company, allowing them to deny you and then file an appeal with the DMC. DMC rules in favor of the patient almost 90% of the time here.
If it is a self-insured plan, they are able to get around it- your only recourse is to petition your company to include the services. I would include the information that Crimson Wife included.
Keep in mind each state is a little different.

July 28, 2012
A MyAutismTeam Member

I Googled "Iowa mental healthy parity law" and found this stating that health insurance must cover psychiatric and psychological care for individuals with autism: http://www.asha.org/Advocacy/state/States-Speci...

July 28, 2012
A MyAutismTeam Member

My employer-provided health insurance has the same policy. There's a brand new Medicaid "opt in" program where, if you make too much money for other state/government services, you can pay a premium and enroll your child in Medicaid as a secondary insurance to pick up things like co-pays and services your private insurance doesn't cover. I'm enrolling both my ASD kids in it -- paying an extra $120 a month for Medicaid is worth it considering the gaps in our employer-provided insurance!

July 31, 2012
A MyAutismTeam Member

Really, you would need to talk specifically to autism parents in your area to see which service providers are a good choice.

July 28, 2012

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