North Dakota State-Regulated Insurance Coverage
North Dakota requires meaningful coverage for autism under state-regulated plans.
Citing the Mental Health Parity and Addiction Equity Act of 2008 (the Act), the North Dakota Department of Insurance issued a bulletin requiring insurance companies to cover autism treatments with limits that are no more restrictive than the limits placed upon benefits for medical and surgical treatments. The bulletin was issued on July 10, 2018 and health benefit plans were given till January 1, 2019 to come into compliance with the new requirements.
To which plan types does the STATE autism insurance law apply?
- Fully Insured Individual Plans - Yes
- Fully Insured Large Group Plans -Yes
- Fully Insured Small Group Plans - Yes
What services are covered by law?
- Behavioral health treatment, including applied behavior analysis
- Pharmacy care
- Psychiatric care
- Psychological care
- Therapeutic care (speech, occupation and physical therapy
Does North Dakota have caps on ABA coverage?
No.
The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) is a federal law that generally prevents group health plans and health insurance issuers that provide mental health or substance use disorder (MH/SUD) benefits from imposing less favorable benefit limitations on those benefits than on medical/surgical benefits. This includes quantitative treatment limits like age and dollar caps.
Where can I find more details about the North Dakota insurance bulletin?
A copy of the North Dakota Insurance Department Bulletin Number 1-2018 is linked.
If you have additional questions, please email advocacy@autismspeaks.org.
Last Updated: December 2019