What do I need to know about autism coverage?

Who is this for?

Michigan Health Insurance – Customer Service – Learn More

Blue Cross Blue Shield of Michigan and Blue Care Network members through the age of 18—up to their 19th birthday.

Most Blue Cross plans cover or help pay for services that treat autism spectrum disorders for members through the age of 18. Standard autism benefits include:

  • Applied behavior analysis, or ABA
  • Physical, speech and occupational therapy
  • Nutritional counseling

Your plan may have requirements before it covers or helps pay for some services. Certain employers can customize the plans they offer. They may change which autism benefits are included, what you need to do to get them, or choose to omit them.

That’s why the most important thing you should do before getting services is check your coverage.

Find your plan’s autism coverage

The easiest way is to log in to your member account. You can do that using our website or the Blue Cross mobile app. 

After logging in, go to My Coverage, select Medical and then What’s Covered. Look for autism. In that section you’ll get information about:

  • Plan requirements for getting services
  • The kinds of services your plan will help pay for
  • How much you pay and your plan pays

Blue Care Network HMO members: If you see in What’s Covered that your plan includes autism coverage, you should also check your Certificate of Coverage. It will have a lot more information. You can find your Certificate of Coverage in your member account:

  • On our website, go to My Coverage, select Medical, then Plan Documents
  • On the app, go to My Coverage, select Medical then scroll down to Certificates and Riders

Don’t see autism listed or have questions about autism coverage?

  • Members who get insurance through an employer: Talk to your HR department or whoever handles your benefits
  • Or, call the Customer Service number on the back of your Blue Cross ID card and we’ll help

Getting services

Plans can vary when it comes to what they require before getting autism services. To help make sure your plan will cover or help pay for treatment, there are certain things you should check.