Anyone from Texas? ABA Insurance Quest.

	Back to Autism Information >> Next Topic
	Our company based in Indiana, and currently has insurance based in Indiana and is considering switching to Encore Insurance, which is based out of Texas. I understand that last year Texas has a law that covers it under insurance.  Does anyone have any details with this insurance company and/or the Texas Law that covers it? I just moved from Texas and the law that was passed said that insurance companies have to provide therapy coverage for kids to age 6. There is info on the Texas Dept. of Insurance website on this. It's www.tdi.state.tx.us. However, I believe under the law that that would apply only to Texas residents, not whether the company is based there, but you can certainly check. Other states are considering this type of legislation. I believe the law only applies if you live in Texas. Yep - only if you live here and only from age 3 to age 6. (my son is 2.5 so we are paying out of pocket for everything right now...) I have become an advocate for this law and I help families fight their insurance companies so feel free to contact me. NEVER QUIT! You WILL win. I was able to obtain coverage for ABA, PT,OT MUsic Therapy, Pediasure, Hippotherapy and Hydrotherapy. There are some exceptions to coverage which confuse people. HB1919 is the law and here are some links about it. I have fought Aetna and won so I am glad to help others do the same. About HB1919: http://www.tdi.state.tx.us/bulletins/2007/cc51.html Here is the actual bill text: http://www.capitol.state.tx.us/BillLookup/Text.aspx?LegSess= 80R&Bill=HB1919 Here is info about ABA: http://www.feathouston.org/HB1919.htm Thanks for the information.  Just for clarification, we live in Indiana, and will stay in Indiana.  Our insurance covers ABA and our son has been getting treatment for the past 3 months (which he seems like a different kid already). He's only 2 1/2 and our local school system takes over after that.  Essentially the cost of this is almost all my paycheck, but I guess I'm in a situation where if it's not covered, it's worthwhile to find a different job. I hope I can help you but I know that this may ..or may not. I am not sure which costs you are having to pay that your insurance doesn't. Are you talking about copays etc? I know that Indiana has an autism law as well. I do not know if it applies for you, but here are some links. I have helped people in a couple of states fight their insurance, but I am not certain if that applies for your situation. The financial bailout had a federal mandate on it that stated that insurance companies must cover mental health as they would physical health http://www.medilexicon.com/medicalnews.php?newsid=124448  H.R.1424 Paul Wellstone Mental Health and Addiction Equity Act of 2007 http://thomas.loc.gov/cgi-bin/query/F?c110:1:./temp/~c1105St VuU:e5719: Indiana. Policies must include coverage for pervasive developmental disorders, including autism. Coverage may not be subject to dollar limits, deductibles, copayments, or coinsurance provisions that are less favorable to an insured than those that apply to physical illness. Insurers and HMOs cannot deny or refuse to issue coverage on, refuse to contract with, refuse to renew or reissue, or otherwise terminate or restrict coverage on an individual because of a pervasive developmental disorder diagnosis (Ind. Code §§ 27-13-7-14. 7 and 27-8-14. 2-1 through 27-8-14. 2-5).   Resources for fighting insurance: http://www.autism-pdd.net/forum/forum_posts.asp?TID=18097&am p;KW=fighting+insurance Easter Seals autism profiles (including insurance law info) for all 50 states: http://www.easterseals.com/site/PageServer?pagename=ntlc8_au tism_state_profiles
	Copyright Autism-PDD.net