States mandating autism insurance coverage
Sometimes mandated benefits are for services such as newborn and infant hearing screenings, lead poisoning screenings, and childhood immunizations.
These types of mandated benefits have the potential to save costs to the health care system as a whole by catching conditions before they become severe and expensive to treat.
Learn more about state laws that mandate or regulate mental health benefits on the National Conference of State Legislators website.
Early Intervention Ten states have a mandated benefit for Early Intervention services for children from birth to age three.
Self-insured employers are exempt from all state mandated benefit laws under the provisions of the federal ERISA (Employee Retirement Income Security Act) law.
They may choose to follow state laws, but they are not required to do so.
States may decide to include coverage for other services and supplies related to hearing screening and treatment.
They are Arkansas, Colorado, Connecticut, Delaware, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Minnesota, Missouri, New Hampshire, New Jersey, New Mexico, North Carolina, Oklahoma, Oregon, Rhode Island, Tennessee, and Wisconsin.
Coverage varies by state, as each state sets its own standards for any age restrictions, amount and duration of the benefit, and provider qualifications.
States may vary in terms of the type of health plan affected by the law, who they make eligible for a given benefit, what it covers, or the dollar amount an insurer may be obligated to pay for an enrollee receiving the benefit.
For example, a mandate for mental health parity may mean unrestricted access to mental health services in one state or within a particular type of health plan, or it may mean that individuals can only receive a certain number of mental health visits or hospital days if those benefits are also restricted for physical health services.