Re: Possible increase in insurance coverage denial as a result of our new Autism Law??

December 24, 2008

, when I first heard of this law being proposed, I posted here that the

impact would be families being denied coverage and increases in premiums. The

only ones making out are those who are employed by the large corporations. My

daughter has been denied many times (a couple from BC/BS, Humana, Aetna, etc))

because of her autism when we applied for individual coverage. Those of us

working for smaller businesses (like my husband) or have their own policies are

now in danger of losing them or facing huge increases or the insurance company

has a 'rider' where coverage for a certain condition is denied (I was denied

coverage for anything related for weight loss the last time we had individual

insurance).

I'm sorry that you've been denied. You can try contact Illinois' Department of

Insurance to see if you have a case.

Finato

www.AngelSpeaks.com

www.wegrowdreams.org

From: crzymomf3@... <crzymomf3@...>

Subject: Possible increase in insurance coverage denial as a result

of our new Autism Law??

" Illinois Parents of Adult " <IPADDUnite >, " Autism chicago "

Date: Wednesday, December 24, 2008, 10:28 AM

Just curious, has anyone experienced, or heard of others

experiencing, an increase in denials of health insurance coverage as a result of

our new Illinois Autism Law?

I have always expected a larger premium for families with a child with Autism,

but having just received a " denial of health care coverage " for my sons because

of their Autism, I am wondering what good the law will do us all if insurance

companies begin/increase their denials of health insurance coverage for families

affected with Autism. Isn't this just a way for them to get out of complying

with the new law. And this denial comes from a very reputable Illinois

insurance company (BCBS of Illinois).

December 26, 2008

I thought the law was going to do the exact opposite of what you're describing.

How did you obtain coverage with BCBS IL? Was it through an employer, or bought

privately?

Could you reply to the group with the exact language BCBS used to state they

were denying coverage?

Stay calm in the meantime. Sometimes with insurance coverage is denied because

the MDs didn't code the diagnosis or treatment the was the insurance people

wanted it.

-Gail

(who used to be in a BCBS plan)

From: crzymomf3@... <crzymomf3@...>

Subject: Possible increase in insurance coverage denial as a result

of our new Autism Law??

" Illinois Parents of Adult " <IPADDUnite >, " Autism chicago "

Date: Wednesday, December 24, 2008, 12:28 PM

Just curious, has anyone experienced, or heard of others

experiencing, an increase in denials of health insurance coverage as a result of

our new Illinois Autism Law?

I have always expected a larger premium for families with a child with Autism,

but having just received a " denial of health care coverage " for my sons because

of their Autism, I am wondering what good the law will do us all if insurance

companies begin/increase their denials of health insurance coverage for families

affected with Autism. Isn't this just a way for them to get out of complying

with the new law. And this denial comes from a very reputable Illinois

insurance company (BCBS of Illinois).

December 26, 2008

The people who proposed the bill wanted everyone to think that way. I remember

reading in a statement that they prepared that they did not anticipate an

increase in premiums.

When I applied for individual health insurance, I had called them ahead of time

to see if they would cover someone with autism and I got the run around (they

said it was based on their review of the application, yeah, right). Angel was

declined because of her preexisting condition - autism. All of the carriers

declined her.

The only BCBS coverage we've had for Angel was group coverage through an

employer.

I believe that Illinois Comprehensive Health Insurance Plan is administered by

BCBS. However, unless you come from a HIIPA plan with I believe 18 months of

continuous coverage, there is a six month wait for preexistings.

When Illinois expanded the KidCare program into All Kids (the only good thing

Blago did for this state), then income levels were drastically increased and we

were able to get Angel covered until her 19th birthday (it's 19 if they are

still in school, otherwise, 18).

The reason why I didn't think that was a good law is because I knew people like

me (thank God Angel is now over 18) would not get coverage for our autistic

children unless we worked for a large company. Those of us working for smaller

companies or self employed will be in worse shape now.

Finato

www.AngelSpeaks.com

www.wegrowdreams.org

From: crzymomf3comcast (DOT) net <crzymomf3comcast (DOT) net>

Subject: Possible increase in insurance coverage denial as a result

of our new Autism Law??

" Illinois Parents of Adult " <IPADDUnite@gro ups.com>, " Autism chicago "

<AutismNews@gro ups.com>

Date: Wednesday, December 24, 2008, 12:28 PM

Just curious, has anyone experienced, or heard of others experiencing, an

increase in denials of health insurance coverage as a result of our new Illinois

Autism Law?

I have always expected a larger premium for families with a child with Autism,

but having just received a " denial of health care coverage " for my sons because

of their Autism, I am wondering what good the law will do us all if insurance

companies begin/increase their denials of health insurance coverage for families

affected with Autism. Isn't this just a way for them to get out of complying

with the new law. And this denial comes from a very reputable Illinois

insurance company (BCBS of Illinois).

December 28, 2008

I am not sure if you are referring to new policies being written, or

old policies being renewed. The new law may not prevent insurance

companies from refusing to write new contracts for families with a

child with autism. However, if there is an existing policy, the

insurance company cannot refuse to renew it.

Section 356z.11(e) states " An insurer may not deny or refuse to

provide otherwise covered services, or refuse to renew, refuse to

reissue, or otherwise terminate or restrict coverage under an

individual contract to provide services to an individual because the

individual or their dependent is diagnosed with an autism spectrum

disorder or due to the individual utilizing benefits in this Section. "

http://www.geocities.com/fishstep/SB1900.html/

As for large, self-funded plans of employers, to exclude an individual

with a disability (health factor) would violate the Parity section of

" HIPPPA. " However, that law would not require the plan from providing

a coverage which would benefit that individual. The new 2008 Parity

law (effective 2010) strengthens the Parity law of the 1996 HIPPPA, by

requiring no greater dollar copayments or deductibles for mental

health, and no separate limit on the number of annual visits; however,

it does not require any specific type of treatment to be included in

the plan.

http://www.geocities.com/fishstep/ERISA-Parity.html

>

> Just curious, has anyone experienced, or heard of others

experiencing, an increase in denials of health insurance coverage as a

result of our new Illinois Autism Law?

>

> I have always expected a larger premium for families with a child

with Autism, but having just received a " denial of health care

coverage " for my sons because of their Autism, I am wondering what

good the law will do us all if insurance companies begin/increase

their denials of health insurance coverage for families affected with

Autism. Isn't this just a way for them to get out of complying with

the new law. And this denial comes from a very reputable Illinois

insurance company (BCBS of Illinois).

>

December 31, 2008

They can't refuse to renew it, but they sure can ask for a much larger premium.

One of my clients was paying $2500 a month for health insurance for himself

only. Years before, he was seriously injured on the job (self employed - no

workman's comp) and had thousands of dollars of medical bills. Each year, the

insurance company did a huge increase on him to make it up.

Finato

www.AngelSpeaks.com

www.wegrowdreams.org

From: fishstep <fishstep@...>

Subject: Re: Possible increase in insurance coverage denial as a

result of our new Autism Law??

IPADDUnite

Date: Sunday, December 28, 2008, 7:55 AM

I am not sure if you are referring to new policies being written, or

old policies being renewed. The new law may not prevent insurance

companies from refusing to write new contracts for families with a

child with autism. However, if there is an existing policy, the

insurance company cannot refuse to renew it.

Section 356z.11(e) states " An insurer may not deny or refuse to

provide otherwise covered services, or refuse to renew, refuse to

reissue, or otherwise terminate or restrict coverage under an

individual contract to provide services to an individual because the

individual or their dependent is diagnosed with an autism spectrum

disorder or due to the individual utilizing benefits in this Section. "

http://www.geocitie s.com/fishstep/ SB1900.html/