Insurers To Provide Coverage For Autism
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Insurers To Provide Coverage For Autism
Insurers can cover people with autism after Monday's budget signing.
Reporter: Barclay Pollak
Email Address: bpollak@nbc15.com
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UPDATED Monday, June 29, 2009 9:15 p.m.

A big break for families coping with autism.

They'll be able to get help from their insurance company soon.

Insurance companies must now provide people dealing with autism coverage.

Wisconsin is only the 18th state to do this.

And it was only possible because of a provision left in this year's budget.

Just a few years ago Kadin Crute's parents couldn't imagine a scene like this.

" We have seen wonderful progress in our son."

In February 2006 Kadin was diagnosed with autism.

His parents say he was unresponsive to people, toys and just about everything else.

" You could shake car keys behind his head and he would not react. "

It wasn't until he started treatment that things turned around.

In this file footage Kadin is hard at work in therapy.

Something his family almost couldn't afford.

" I think at the most expensive point it was around $860 a week and that still was kind of partial therapy. "

For almost a year Kadin's parents paid for their son's treatment out of pocket.

When Kadin was diagnosed insurance companies in Wisconsin didn't cover treatment for the disorder.

That changed Monday when Governor Doyle signed the budget.

" Well we're really happy."

Dr. Glen Sallows works for the Wisconsin Early Autism Project in Madison.

He says before parents didn't have many options.

They could pay for treatment out of pocket like Kadin's parents or try to get the state to pay for it.

" So the waiver kind of helped out in that way but it had some limitations."

It had a huge waiting list and a cap on the amount time a person could be treated.

" Three years is enough to get them to be able to speak and understand what other people are saying to them. But the social difficulties which is really the most devastating takes a little bit longer than that. "

Kadin's treatment is almost over.

His parent's say they could've used help from an insurer.

But they're happy to know other parents will get the help they never did.

Under the new plan insurers will be able to provide at least $50,000 in coverage for intensive level services per year.

And at least $25,000 for nonintensive level services per year.

Those numbers can be adjusted yearly beginning in 2011.

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Posted Monday, June 29, 2009 -- 6:22 p.m.

Monday's budget signing by Governor Jim Doyle may provide some relief to families dealing with autism.

Under the new budget, insurers will have to provide coverage for the disorder.

Policies covering autism would have to include at least $50,000 minimum coverage for intensive level services.

And at least $25,000 minimum coverage for nonintensive services.

These minimums can be adjusted annually beginning in 2011.


Latest Comments

Posted by: anon Location: madison on Jun 30, 2009 at 09:53 AM

It is about time. Just think of how many kids are on Medicaid that can now be covered under the family insurance plane. Could save the state budget a little!
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Posted by: stacey Location: madison on Jun 29, 2009 at 09:08 PM

while i am happy that there will finanlly be coverage for individuals with autism (and no, i do not have any children with this diagnosis), i do believe that giving this diagnosis "free reign" to just be paid vs being able to review for medical necessity is going to really hurt insurance companies and ultimately those who pay for insurance. a minimum of $50000 is huge.....no other diagnosis/illness is just "paid out".
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Posted by: D Location: Madison on Jun 29, 2009 at 06:47 PM

All i can say is everyone that has health insurance HOLD ON TO YOUR WALLETS, if Insurers cover Autism they should be made to cover All Pre existing conditions period
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