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Autistic adults face health insurance problems

Lana Bandoim's picture

Adults with autism continue to face ongoing problems with health insurance, and age is at the center of the debates. Most programs offer coverage through the age of 21, but families are left with the difficulty of finding new services once their loved ones are older. This leaves thousands of autistic people without the coverage they need.


People who have autism spectrum disorder (ASD) are often faced with the dilemma of finding good health insurance once they are over the age of 21. PBS recently addressed this problem by highlighting that many people depend on applied behavioral analysis, yet they cannot afford it on their own. Families do not want to stop the treatments for adults, so they struggle to find a way to pay for them.

It is important to note that Medicaid and CHIP (Children’s Health Insurance Program) are required to cover people with autism through the age of 21. However, there are no current laws that force these government programs to provide help beyond this age. This leaves a vulnerable part of the population already struggling in lower tax brackets with the problem of finding new insurance plans. Autism does not magically fade away once a person turns 21, so the age restrictions are part of ongoing debates about how health insurance should treat people with this condition.

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Despite changes, there are still reports of autistic people being denied coverage by health insurance companies. There are also issues with Medicaid coverage in some states because the treatment programs are viewed as too expensive. It is estimated that a family can easily spend $40,000 to $50,000 on autism services which include behavioral therapy in one year. State legislators in some areas have been able to enact laws that protect families and prevent health insurance companies from denying essential coverage.

Read more about autism:
Medicaid coverage of autism services ordered by CMS
Police handcuff autistic boy and force him to stay on top of squad car trunk

Image: Cinaminbx47/Wikimedia Commons