Self Funded Private Insurance

If your employer’s self-funded plan has not adopted coverage under ARICA, there are several strategies and alternatives. They are outlined below. 

We recommend contacting us for assistance and advice on what might be the best alternative for you.
You may want to ask questions and investigate some alternatives:
  1. Find out whether your company’s plan covers the treatment you are looking for. (It may, even if it doesn’t comply with ARICA).
  2. Advocate with your company to consider adopting coverage under ARICA. We can assist you with resources, materials, and advice on the best way to do this.
  3. Consider asking your company to make an exception to cover the treatment you need. They can do this without changing their policy. (Note, this is usually reviewed at the corporate level, not by the insurance company which administers the plan).
  4. If there are other diagnoses in addition to autism, explore with your clinician the feasibility of obtaining treatment for that condition. For example, a plan that is not subject to ARICA may not cover speech therapy for autism. But if a person also has a diagnosis of apraxia, speech therapy may be covered for the apraxia.
  5. Explore obtaining an alternative policy that is subject to ARICA. There may be options through a spouse’s employment, or through the Connector open enrollment.
  6. For a child receiving services through Early Intervention, options should be reviewed well before the child turns 3. Otherwise, ARICA coverage may not be in place when the child graduates from EI, and there could be a wait of up to a year until the next open enrollment opportunity.

 

If you need any further assistance please contact the Autism Insurance Resource Center.