Health Insurance Coverage

PA Autism Insurance Act (Act 62)

The document covered here is the PA Autism Insurance Act (Act 62).

You may download a PDF of the original document HERE.

In Brief, the Document States:

An insurance company is not permitted to treat someone on the autism spectrum any differently than they treat any other person that they cover.

In Greater Detail, the Document States:

This notice to the insurance companies defines acceptable exclusions or limitations of the insurance coverage for autism spectrum disorders. The law requires coverage of diagnostic assessment and treatment of autism spectrum disorders by certain insurance companies or contracts.

This insurance act requires coverage for autism spectrum disorders which includes, medical, psychological, and rehabilitative care. Even if these specific treatments are excluded from the person’s insurance policy, the insurance company must still cover these treatments for a person on the autism spectrum if they are deemed medically necessary and prescribed.

There are types of treatments not covered under the law. If an insurance company does not cover specific treatments such as acupuncture for any insured person, the company is not required to provide this coverage for treatment for autism spectrum disorders.

The insurance company may limit the amount of coverage that they provide so long as it is the same limitation for every person that they cover. If a policy requires services be provided by a participating provider, then this requirement also applies to those on the autism spectrum.

Questions Regarding This Notice May Be Addressed To:

Shelley D. Bain, J. D.
Director, Bureau of Accident & Health Insurance
Insurance Department, 13th Floor
Strawberry Square, Harrisburg, PA  17120
ra-in-autism@pa.gov

Further Resources

View the DPW’s web site on the PA Autism Insurance Act (Act 62). The Department of Public Welfare, the Pennsylvania Insurance Department, and the Department of State are working together to implement the PA Autism Insurance Act.

Act 62 Statute – House Bill 1150 was signed into law on July 9, 2008 and became Act 62. View the bill and its history here. The portion of the bill that deals with autism insurance begins on page 5, line 17.

View information about issues such as coverage, requirements, and treatments in the Autism Insurance Fact Sheet.

View the letter sent to Pennsylvania families about Act 62, and find out if the Autism Insurance Act applies to your child.

View the Frequently Asked Questions and Answers About the Autism Insurance Act. Subjects include general issues, covered services, private insurance, qualified providers, and licensing.

View the Act 62 Quick Facts, provided by the PA Health Law Project.

  • Autism Resources

  • Highmark Walk for a Healthy Community

    Highmark Walk for a Healthy Community

    Saturday, May 18th

    Stage AE on the North Shore

    REGISTER AS A WALKER OR DONATE HERE

  • Autism Friendly Performance of Disney's The Lion King

     

    Saturday, September 21, 2013 at 2:00 p.m.
    The Pittsburgh Cultural Trust is proud to partner with Disney Theatrical Productions for this very special performance of Disney’s The Lion King. This presentation will be a sensory-friendly performance that allows families with members on the Autism spectrum to experience a regular Broadway production with several alterations that meet the needs of the audience. Pittsburgh will be the third city to offer this type of program, and The Pittsburgh Cultural Trust remains committed to making theater and the arts accessible to all audiences.
    The ticket purchasing process is as follows:
    • a brief questionnaire will need to be completed
    • choose the ticket price you would like to order
    • you will then receive a phone call from The Benedum Center                                                     asking for seat selections, based on your family’s needs

    PURCHASE TICKETS HERE

     

  • Three Rivers Rowing Event

    June 8, 2013, 1:30 p.m. – 3:30 p.m.

    From Enjoy a day learning about the Adaptive Paddle Program at Three Rivers Rowing Association — tour the facility, explore the equipment, try the practice tanks and sit in a dragon boat in the water.  Children ages 12 and older are encouraged to participate, along with their families and support staff.

    REGISTER HERE

     

  • Amusement Park Tickets

    SINCE THERE ARE A LIMITED NUMBER OF TICKETS, PLEASE CALL

    AUTISM CONNECTION OF PA’S OFFICE AT 412-449-0165 FOR ORDERS.  THANK YOU

     

    IDLEWILD — $20.00 — tickets valid WEEKDAYS only, May 27th, June 7th-August 8th and September 2nd

    SANDCASTLE — $15.00 — tickets valid any day

    KENNYWOOD — $23.00 — tickets valid any day in May, June and September.  Valid WEEKDAYS in July and August.