AS Diagnosis and Health Insurance

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Those of you in the US, once you were diagnosed with AS/autism, did your health insurance rate increase? I'm a little nervous because I'm preparing for an evaluation soon, and while I don't currently pay for my own insurance, I don't want to find that I've been blacklisted and no one will take me on, or my deductible is through the roof when I do start paying for it, simply because I have a diagnosis of ASD.

I would like to find out too. Especially now that ObamaCare is now in effect. God help us.

I thought I heard the other day on the news that one aspect of Obamacare is that insurance companies cannot blacklist someone due to a pre-existing condition.

I'm no expert on the subject, however.

Well, I guess this looks like a promising start:

http://obamacarefacts.com/pre-existing-conditions.php

I think that has to do with denying coverage. Not whether or not they can raise premiums.

I'm on Medicaid because I'm disabled. I have noticed, however, that depending on where you're from, your premiums can vary from $80/month to $300/month. That's a pretty big difference and is cost prohibitive to those who don't make that much. I was a nurse and I find that Obamacare was too expensive. One good thing: Obamacare doesn't care about pre-existing conditions. Originally, I would've been denied because of my history of a stroke and Asperger's Syndrome. Those issues don't factor into the new Affordable Care Act (ACA) program.

If someone is diagnosed as developmentally disabled, dont they automatically qualify for medicaid?

here is something interesting to read:

http://jtwalters.hubpages.com/hub/Obamacare-for-Autism

Obamacare cares about pre-existing conditions.

Pre-existing conditions can be excluded with an exclusionary clause on the insurance. All the insurance policy has to say is "this policy does not provide insurance for autism".

I have a pre-existing condition with my jaw (TMJ tendon/joint jaw dislodgement), and the insurances on the state exchange all exclude coverage for it.

I'm interested to know where the author of that article got her information, because according to the US department of Health and Human Services, autism is included as a pre-existing condition under the Affordable Care Act:

http://www.hhs.gov/autism/factsheet-aca-autism.html

I don't know. just some random article I stumble across while on this topic. just though I'd toss it out there.

Taken from Humana plan from my state exchange marketplace website ( http://apps.humana.com/marketing/docume ... le=2059174 )

Limitations and exclusions (things that are not covered)
This is an outline of the limitations and exclusions for the Humana individual health plan listed above. It is designed for convenient reference. Consult the policy for
a complete list of limitations and exclusions. Your policy is guaranteed renewable as long as premiums are paid. Other termination provisions apply as listed in the
policy. Unless specifically stated otherwise, no benefits will be provided for, or on account of, the following items:

52. Services and supplies which are:
a. Rendered in connection with mental
illnesses not classified in the International
Classification of Diseases of the U.S.
Department of Health and Human Services;
b. Extended beyond the period necessary
for evaluation and diagnosis of learning
and behavioral disabilities or for mental
retardation;

So they pay for an evaluation and diagnosis but have a "beyond the period necessary " clause to cut you off if they want. l would guess obamacare is not that specific and insurance companies can find loopholes.

Children often do, and I don't fully understand the rules but often they do. A person may or may not continue to qualify as an adult is my understanding. Which does make some sense as some people gain a lot of skills and can work, but might have needed a lot of time and support to get there. There is a lot more understanding of developmental problems in systems that work with kids, though. And for a person growing up just requires planning what's needed and how to access.

Children often do, and I don't fully understand the rules but often they do. A person may or may not continue to qualify as an adult is my understanding. Which does make some sense as some people gain a lot of skills and can work, but might have needed a lot of time and support to get there. There is a lot more understanding of developmental problems in systems that work with kids, though. And for a person growing up just requires planning what's needed and how to access.

As I understand, in many states' insurance policies there may be a specific exclusion for autism spectrum disorders; specific exclusion means that the diagnosis and/or treatment is singled out for exclusion in the plan contract. It doesn't matter if the care is medically necessary or not, because the plan contract singles out autism spectrum disorders for exclusion; the question of medical necessity therefore becomes a moot point. Here is an article on the matter with a list of states that mandate insurance carriers in those states to cover the diagnosis and treatment of autism spectrum disorders:

http://www.pewstates.org/projects/state ... 5899496217

Basically, as it currently stands under the ACA, insurance companies may not drop your coverage, refuse you to issue you a policy, or charge you more for a pre-existing condition, but the carriers may still exclude coverage for categories of medically necessary care in the plans they issue, may still have blanket bans on treatment (medically necessary or not) for certain conditions, provided the law does not specifically require the insurance carrier to cover the diagnosis and/or treatment. It's not just autism that has this problem, but GID/gender dysphoria, too, where in most states all the plans on the exchanges specifically exclude all care (medically necessary or not) for GID/gender dysphoria.

Now, as I understand, for autism spectrum disorders, oftentimes your therapist can get around this problem by billing a different diagnosis, such as depression or anxiety.