For those with developmental disabilities such as autism, life can be filled with a few more obstacles. Finding coverage for medical services can be one of these hurdles for the simple fact that many insurers are less willing to cover the medical needs that these types of developmental disabilities demand, which is why many individuals rely on Social Security disability benefits or other public assistance to cover the costs.
Although enactment of the Affordable Care Act has caused a good deal of controversy, it is a law that is currently in place and enforceable. Contained in the legislation is a vast array of requirements, some of which have not held the attention of the media. One of these lesser-known requirements addresses developmental disabilities.
Under the legislation, insurance carriers would be required to extend services coverage to those with developmental disabilities, including autism and cerebral palsy. This coverage includes “rehabilitative and habilitative services and devices” that individuals with these types of conditions require.
After dealing with claim denials and appeals, even those that end up receiving final approval for habilitative services can quickly become discouraged. “It becomes exhausting,” said one mother of a child with cerebral palsy. For her, the new portion of the legislation provides hope that soon all group plans, not just individual or small group plans, will also provide this type of necessary coverage.
Disability advocates are concerned that even though this legislation extends coverage to those with developmental disabilities, insurers will find their way around the situation. Those that are struggling to cover the costs associated with living with a disability can talk to a SSD attorney to determine what types of assistance they may be eligible for.
Source: Disability Scoop, “Health Law Adds Coverage For Developmental Disability Services,” Michelle Andrews, Jan. 14, 2014Social Security Administration, “12.00 Mental Disorders — Adult,” Jan. 16, 2014