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Autism Insurance Resource Center 2025

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The document provides information about the Massachusetts Autism Insurance Law (ARICA), which mandates health insurers in Massachusetts to cover the diagnosis and treatment of Autism Spectrum Disorder. It outlines the law's implementation date, types of policies affected, coverage details, and the absence of age limits or coverage caps. It also clarifies that ARICA does not cover educational services and offers guidance on how individuals can verify their coverage.

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

When did insurance start covering mental health?

Not until after World War II did insurance policies include mental health services, when insurers began covering some hospital psychiatric care (Goldman, Sharfstein, and Frank 1983).

What things does insurance cover for autism?

In fact, most insurance plans will cover autism therapy, including ABA therapy and autism evaluations. Coverage varies based on your location and plan, so its important you check with your provider.

When did insurance start covering ABA?

5. California (Effective July 12th, 2011) Applied Behavior Analysis.

Will insurance cover ABA without autism diagnosis?

Insurance and Funding Concerns Insurance coverage for ABA therapy will, more than likely, require an official autism diagnosis.

When did insurance start paying for ABA?

In 2011, when SB 946 was passed, insurance coverage for behavioral health treatment became mandatory for individuals with autism and pervasive developmental disorders (a diagnosis given prior to the release of the DSM-5 in 2013, when all autism conditions were folded into autism spectrum disorder).

When did ABA become a thing?

In the mid-1960s, Dr. Ivar Lovaas developed a program designed to teach language to children with autism, using the principles of applied behavior analysis, with the goal of preventing children from being institutionalized.

Does insurance pay for autism diagnosis?

The law says that all California-governed health insurance companies must pay for diagnosis and evidenced-based treatment for autism NO MATTER the persons age or IQ. Typically families access ABA (sometimes call BHT or Behavioral Health Treatment, speech and occupational therapy services.

Do children with autism qualify for MassHealth?

Children under the age of 21 who have been diagnosed with autism and are covered by MassHealth Standard, CommonHealth and Family Assistance are entitled to medically necessary ABA services. Coverage is also available to members who have MassHealth as secondary insurance.

Autism Insurance Resource Center 2025

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