Vermont Insurance Requirements for Autism Spectrum Disorder

The information below is collected from state statutes and regulations. The information is reviewed on an annual basis. Please be advised that laws, regulations, and policies may change at any time, so always check with your state for the most up-to-date information.

Note: Certain insurance plans are exempt from state mandates. Please contact your plan administrator to see if your plan includes state mandated autism spectrum disorder benefits.

Specific Insurance Mandate

The state of Vermont has a specific autism mandate.

The mandate requires a health insurance plan to provide coverage for the diagnosis and treatment of autism spectrum disorders, including applied behavior analysis supervised by a nationally board-certified behavior analyst, for children, beginning at 18 months of age and continuing until the child reaches age six or enters the first grade, whichever occurs first. Treatment includes: habilitative or rehabilitative care; pharmacy care; psychiatric care; psychological care; and therapeutic care (includes services provided by licensed or certified speech language pathologists, occupational therapists, physical therapists, or social workers), if the physician or psychologist determines the care to be medically necessary. The provisions go into effect on or after July 1, 2011, on such date as a health insurer offers, issues, or renews the health insurance plan, but in no event later than July 1, 2012.