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Insurance Coverage for Autism


City of Portland employees have been struggling to get insurance coverage for applied behavior analysis (ABA) therapy for family members suffering from autism, especially children. Now, the city’s health insurance will cover it.

The city council agreed unanimously to make this possible, after families seeking the benefits were faced with countless hurdles to receive coverage from their city-sponsored insurance plans. Anastasia Puha says getting coverage for her autistic daughter’s ABA therapy meant multple claim appeals, third-party reviews and requesting information from other states to prove the treament was a medical necessity.

The U.S. Office of Personnel Management just recently classified ABA therapy as a medical treatment.  In Portland, medical necessity must still be proven to receive the benefits. 

 

Are you a city employee? Do you have a child with autism? What’s your experience with applied behavior analysis therapy?

GUESTS: 

  • Toby Rates: Executive director of the Autism Society of Oregon
  • Anastasia Puha: Wife of city employee covered under the City of Portland health insurance plan and mother of a child with autism 

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