In the first year or so after my oldest son was diagnosed with autism at the age of 2 ½, my husband and I spent about $10,000 on therapies, none of which were covered by our insurance plan. In the 11 years since, raising two boys with autism has not only meant considerable expenses but also that I have had to work less and earn less than I would have otherwise. Many other autism families I know face similar, and in some cases more difficult, financial struggles. In every one of those families, it is the mothers who must serve as the caregivers, therapy coordinators, education advocates and all-around experts for their children.
North Carolina has a higher autism rate than the nation as a whole – 1 in 70 children in our state versus 1 in 88 nationally, according to the Carolina Institute for Developmental Disabilities.
Early intervention – in the form of behavioral, developmental, speech and occupational therapies – can be tremendously beneficial to children with autism, enabling them to function better in school and, in some cases, significantly reducing their need for services and care over the course of their lives.
So it would make sense that a parent of a child with autism would want to provide him with the best therapy possible, and as much of it as possible, as early in his life as possible. But such intensive treatment can be cost-prohibitive because most insurance plans don’t cover therapies for autism. Historically, insurance companies have argued that such therapies are educational, not medical, in nature.
As a result, families coping with autism face difficult choices. The costs can be tremendous. It’s not uncommon for one parent to have to quit working or cut back on work hours because finding care for a child with autism can be difficult, if not impossible. Then there are the special diets and multiple supplements recommended by various doctors and specialists. Speech and occupational therapy can run $60 to $75 a session, with at least one session of each every week. Developmental therapy costs several hundred dollars a month, and behavioral therapy, the most widely recognized treatment for autism, can run thousands or even tens of thousands of dollars a year.
Currently, 32 states have laws on the books that require state-regulated health plans to provide autism-related coverage. North Carolina does not, although there is a bi-partisan bill now moving through the legislature that would require insurance companies to cover doctor-ordered treatments that reduce the symptoms of autism and promote independence. Visit the Autism Society of North Carolina’s website for all the details.
Requiring insurance companies to cover autism treatments would likely save the state millions of dollars in educational supports and long-term-care costs. But more importantly, this bill would help thousands of North Carolina families facing an often difficult and always expensive journey.