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Mandated coverage for autism spectrum disorders

November 1, 2012

On August 13, 2012, the state of Delaware passed a law that requires health insurers to cover the diagnosis and treatment of autism spectrum disorders (ASD), which are any of the pervasive developmental disorders as defined by the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM), and include Asperger?s Syndrome, Rett Syndrome, childhood disintegration disorder, and pervasive development disorder. Coverage for ASD, in accordance with this mandate, will be effective December 11, 2012 for members in Delaware. Covered services of ASD are subject to the copayment, deductible, and coinsurance provisions of the member?s benefits plan, but will not be less favorable to an individual than the cost-sharing that applies to physical illness under the member?s health benefit plan. For detailed information about our coverage for ASD, please refer to our Medical Policy website.

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