Texas amends age limit for autism spectrum disorder benefits
The 2009 Texas Legislature amended the current autism spectrum disorder (ASD) mandate, extending the age limit from age six to age 10 for generally recognized services prescribed in relation to ASD.
Blue Cross and Blue Shield of Texas (BCBSTX) currently provides benefits for all generally recognized services prescribed in relation to ASD by primary medical care physicians/providers of covered members between the ages of birth and six years.
To comply with the new mandate, these benefits now will be available for members from birth up to age 10.
After the covered member’s 10th birthday, benefits for eligible expenses for the treatment of ASD will be available as otherwise covered under the member’s group benefit plan.
The provisions of the new law will go into effect on the group’s next contract renewal/effective date beginning in 2010.
Exception: The state mandate does not apply to self-funded groups; however, during the benefit renewal period, these groups do have the opportunity to elect coverage options mirroring the state-mandated benefits.