Private Health Insurance Resources for Young Autistic Adults

Having private health insurance for your son or daughter after 18 years of age may prove to be more advantageous financially than the government insurance Medicaid.  Parents have the option of keeping their private health insurance as the primary health insurance for their young adult and Medicaid as the secondary.  The Affordable Care Act of 2010 states that private health insurance plans are required to allow parents to keep their dependent children on the family health insurance plan until the child turns 26 or works at a job that offers employer-sponsored insurance.

Parents will often ask which insurance company has the best health care plan for the child with autism.  Comparison shopping is always the best way to answer this question, but getting a PPO plan from any insurance company will always provide the most coverage especially for out-of-network doctors or specialists.  This definitely gives you an advantage over HMOs or Medicaid which are much more limited in their coverage.  Also, insurance plans are beginning to offer free preventative health care, no longer put a lifetime cap on the amount of care they will cover, will not cancel your coverage over a mistake in the paperwork and as of 2014 no one can be denied insurance due to a pre-existing condition.  However, careful review of private health insurance policies is advisable because some companies allow continued coverage if the child is a full time student or if the adult child is disabled and the parents continue to provide 50% or more of the adult child's support and maintenance.  However, if your adult child is receiving SSI benefits some aspects of SSI payments are based on whether or not the young adult is claimed as a dependent by his or her parents.

In addition, the Autism Insurance Reform Act has passed legislation in certain states to eliminate discrimination on the basis of the autism diagnosis code ICD-9 299.00.  If your state has not passed this legislation, then there is a Supreme Court ruling that took place on May 7, 1991 "Kunin vs. Benefit National Life" in California that states;"... autism is not a mental illness under the applicable insurance policy, and therefore benefits are greater than the limitation set forth in the policy".  Any parents whose insurance claims for autism treatment are being denied or limited because of "mental illness" can refer to this Supreme Court Ruling which is approved nationwide.  Documents can be acquired from the Autism Research Institute.