BeneTip: Is treatment for autism spectrum disorder covered by our health plan through Medical Mutual?
Effective May 1, 2022, Medical Mutual has expanded coverage to include screening, diagnosis, and treatment of autism spectrum disorders (ASD). Covered services now include:
- Speech/language therapy, occupational therapy, and physical therapy performed by a licensed therapist.
- Clinical therapeutic intervention including (but not limited to) applied behavioral analysis, if provided or supervised by a professional licensed, certified, or registered by an appropriate agency of Ohio for the performance of such services within a treatment plan.
- Mental/behavioral health outpatient services performed by licensed psychologist, psychiatrist, or physician providing consultation, assessment, development, or oversight of treatment plans.
- Prescription medication.
Treatment for ASD means evidence-based care and related equipment prescribed or ordered for a covered individual diagnosed with an ASD. Treatment for ASD must be from a licensed physician who is a developmental pediatrician or a licensed psychologist trained in autism and determined to be medically necessary and pre-authorized.
For information regarding coverage for ASD or other health benefits, contact Medical Mutual at 1-800-382-5729.