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Insurance age cap removed for autism treatment in Mississippi

Since 2014 when insurance companies began covering the Applied Behavior Analysis treatment for children with autism, an age cap of 8-years-old has been in place. Today, Secretary of State Delbert Hosemann has announced that three of Mississippi’s major insurance companies, BlueCross BlueShield of Mississippi, UnitedHealthcare of Mississippi, and Magnolia Health, have decided to lift that age cap.

Applied Behavior Analysis is a leading treatment for children diagnosed with autism, but out of pocket costs can quickly pile up without the proper coverage. Lorri Unumb, legislative director for Autism Speaks, has worked with lawmakers in 46 states on issues like this, but she also has a much more personal connection to this issue.

“For my son’s level of impairment, doctors recommended that he be in an ABA program for 40 hours a week. For that level of intensity, the price tag was about $70,000 a year, and at that time there was no insurance coverage, so our family had to either not get our son treatment or come up with $70,000. We sold our house and moved so that we could afford the treatment.”

Unumb says that price tag is above the average cost of care due to the severity of her son’s diagnosis, but no matter the price, she looks forward to what this will do for families and children diagnosed with autism.

“This is a huge step forward by removing this age restriction to make sure that all children who have this insurance will have access to treatment regardless of their age,” Unumb said.

James Moore, director of autism solutions for Canopy Children’s Solutions and the Chair for the Mississippi Autism Board, discussed the impact that continued treatment with ABA can have on children who receive an autism diagnosis. He says that they have been able to work with children that previously weren’t able to attend schools to eventually transition them into general education.

“The more treatment we can get to these kids, the better and it changes their life trajectory in ways that are almost immeasurable,” Moore said.

The removal of the age cap will not only make ABA more affordable, but Moore says it will help children with autism reach their full potential.

“Every parent wants their child to thrive and have the highest quality of life possible. When a parent knows that there is still an area, whether its social function or communication, that they know they can get that but then can no longer afford it was unfair. To be able to remove that is tremendous and now parents can focus on helping their children reach their highest potential,” Moore said.

Moore also mentioned that many families worried about regression if they were unable to afford care for their child after their 9th birthday and this will ease that worry.

In an effort to increase the number of ABA technicians across the state, Holmes Community College has created a course allows them to become a registered behavior technician. The course will be offered online beginning in March 2018, and it will provide the 40 hours needed to apply for the Registered Behavior Technician credential.

“It gives a gateway to higher levels of the profession where students can take this course, have a passion ignited for ABA and then go on to help us deal with the depleted workforce that we of board-certified behavior analysts in Mississippi,” Moore said. “There are 42 licensed behavior analysts for 11,000 individuals. It’s like a drop of water in the ocean right now.”

According to a media release from Holmes gave the requirements for an RBT.

  1. Be at least 18 years of age
  2. Possess a minimum of a high school diploma or national equivalent
  3. Pass a criminal background check
  4. Complete 40 hours of training (which the PSY 2543 ABA class will satisfy)
  5. Pass the RBT Competency Assessment
  6. Pass the RBT exam

Both Moore and Unumb thanked Hosemann and Insurance Department Commissioner Mike Cheney for their work in getting this age cap removed along with the three companies. Hosemann says that this will those who need care can receive it regardless of age.

“Quality treatment will now be more accessible to those who need it the most.  Parents and caretakers of individuals diagnosed with autism and other developmental disorders will now be covered beyond age 8,” Secretary Hosemann said. “This is an example of our leading healthcare providers voluntarily meeting the changing healthcare needs of our children, and Mike and I sincerely appreciate their efforts.”

An Autism Hotline (1-833-488-6472) and an Autism Insurance Resources website (http://www.mid.ms.gov/autism) have also been created in an effort to make it easier for parents to obtain and understand the type of coverage that is offered.

Secretary Hosemann made the announcement at ABA Capitol Day earlier this week.

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