Autism Mandate

• Requires underwritten groups and individual health plans to provide coverage for the diagnosis and treatment of autism spectrum disorders effective Oct. 15, 2012.
• Autism mandate does not apply to persons covered by the following:
  • Federal programs
    • Eg. FEP, TriCare, VA, Medicare, Medicaid, Medicare Advantage, Medicare Part D
  • MIChild
  • Self-funded employer groups not mandated under the law
    • If opting in – Self-funded groups may also request modifications to standard benefits (i.e. authorization requirements, dollar limits, out-of-state coverage).
• To find out more information about the Autism Mandate or to view a copy of the bill click here.

AAEC Information

• Michigan Mandate states that, prior to services, child must be given an Autism Spectrum Disorder diagnosis by a medical professional and that diagnosis must be confirmed by an AAEC evaluation. Without those to steps insurance will not authorize treatment.
• AAEC Evaluation consists of a 3 pronged evaluation by a psychologist, a speech pathologist, and a pediatrician to get confirmation consensus that the Autism diagnosis is accurate.
• Some AAECs have long wait lists so it is good to get in touch with several to put your name on the list ASAP. May have to travel to a location that’s farther from home to get shorter wait time.
• There are several AAECs located around the state of Michigan.

For information regarding the Blue Cross Blue Shield AAEC, click here.