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June 30, 2009
Dear Parents and Caregivers,
As you may already know, Steven's Law is going to be effective in Arizona this Wednesday, July 1, 2009. Steven's Law requires insurance carriers to provide coverage for medically necessary therapies for children and teens with autism spectrum disorders, similar to the existing coverage for other medically necessary treatments for other disorders. The question is, will your child be eligible for autism-related insurance coverage? See below for a step-by step guide to assist you.
Steven's Law Step-by Step Eligibility Questions:
- Ask the Company/Human Resources Dept. (HR) for whom you work (where you receive your health benefits/insurance) if the plan your family has is a "Self Insured Plan." If they tell you "Yes" - you are not eligible for benefits under Steven's Law. If they tell you "No" go to step # 2.
- If you do not know or are unsure, ask the HR Department if the company has 50 or more employees. If they tell you "No" than you are not eligible for benefits under Steven's Law. If they tell you "Yes" go to step #3
- Ask the HR Department where/in which state your Insurance Plan is "underwritten." If your plan has been underwritten in any state other than Arizona you may not be eligible for Steven's Law.
- Call your insurance company and ask for "Member Benefits." Ask if they (Customer Service) are familiar with Arizona's Steven's Law/Autism Coverage.If they tell you "No" ask to speak to a Supervisor and ask the Supervisor the same questions.
- If they tell you "Yes" ask them if your family (your child) is eligible for the benefits under your plan.
- If they tell you "No" ask them why/what the reason is, and then tell them you want the reason you do not have coverage sent to you in writing.
- If they tell you "Yes" request a list of "Network or Contracted Providers" or "Preferred Providers" for your area. This will give you all of the agencies and/or individuals who are contracted with your insurance company to provide services outlined by Steven's Law.
- Because some Companies have elected to offer this coverage when they are not required to, call your insurance company and ask even if you think you are NOT eligible. If they tell you that you ARE eligible, request it in writing before you make any appointments etc.
We encourage you to take these steps and invite you to then share with us the process by which your insurance company may provide assistance and what they have instructed you to do.
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