Lighthouse Autism Center Prepares Families for Insurance Open Enrollment in November

As a result of changes from the Affordable Care Act (ACA), the Open Enrollment period for insurance is now occurring only once per year. For coverage starting in 2015, the Open Enrollment period is November 15, 2014- February 15, 2015. Individuals may also qualify for Special Enrollment periods outside of Open Enrollment if they experience certain events. So, unless parents of a child with autism have a qualifying event, they will need to take advantage of the Open Enrollment period to make sure they can obtain autism therapy coverage for their child in 2015.

Why parents cannot afford to wait an entire year to enroll

Lighthouse Autism Center typically sees an uptick in clients in the August and September timeframes, when kids go back to school. This increase in numbers stems from parents getting repeat calls from school to pick up a “problematic” child. It is critical for parents with children evaluated and diagnosed with autism to take advantage of Open Enrollment so coverage for therapy can begin promptly in 2015, as needed.

Waiting until the next Open Enrollment period in November 2015 will delay needed therapy for an entire year and can have a negative impact on a child’s development. A child having to delay full-time autism therapy for one year loses out on 2,040 hours of therapy which could have been spent teaching them new skills. One year in the development of a child, depending on the child’s age, can mean the difference between being potty trained, learning to talk, and learning to play well with others. The earlier a child receives services, the better their chances of reaching his/her full potential. Some behavior analysts actually say that one year of a learned inappropriate behavior will result in six months to “unlearn” the behavior and learn a more appropriate one. If undesirable behaviors are compounded, this could essentially add a need for more therapy time than originally necessary.

To read the entire October issue of The Autism Beacon, click here.