Insurance Coverage for People with Autism Spectrum Disorder

Autism is a developmental disorder that can have a far reaching effect on an individual, hampering domains such as the cognitive, language, sensory, emotional and also motor integration and coordination.

Because autism is experienced as a cluster of symptoms, it is very important that families with people who are struggling with autism spectrum disorders take the time necessary to choose an insurance plan that serves their particular need.

Because of state regulation, most coverage plans cover applied behavioural analysis or ABA, which is one-on-one counselling to improve an autistic’s behaviour in different situations. But frequently this is not enough.

Problems Frequently Faced with Health Coverage

Those who have sought out health coverage specifically for autism know just how difficult and painful a process it can be.

Most insurance companies might put up a wall for any number of reasons when you ask for coverage for necessary interventions. You get used to hearing excuses and coverage denials like:

  • The health plan covers only one type of intervention, for example applied behavioural analysis.
  • The health plan does not support a certain kind of autism intervention it describes as “experimental” or not “evidence based” despite proof to the contrary.
  • The health plan will not cover certain interventions except they are administered by a certain type of professional, for example a board certified applied behavioural analysis practitioner.
  • The health plan does not cover certain interventions because they are not considered “health interventions” but rather as “educational interventions”, for example, speech therapy.
  • The health plan covers the intervention…but only up to a certain extent and no more. For example, it may cover up to a few hours of speech therapy a month, as opposed to several hours a week which is what is really needed.
  • The health plan only supports if you use professionals who are part of their network, and an inadequate number of these professionals can have a family travelling vast distances to get help or worse settling for a professional who does not offer the right kind of service.
  • The health plan covers other types of disabilities, but not autism. For example it may cover victims of brain injury but not necessarily autistic persons.

And so on and so forth.

Health insurance for autism

Image Courtesy: Autism speaks

What to Look Out For in a Health Plan

Before adopting any health plan or coverage, you want to find the answers to a few important questions first by peering keenly between the lines.

  • Does the health plan generally cover the service which you are deeply in need of?
  • Do the terms stipulate the need for an in-network health care provider? Is there one within reasonable distance from you whom you feel comfortable working with?
  • Do the terms require the intervention to be done by a professional with a particular type of licensure? Maybe the plan only supports board-certified behaviour analysts. This could be a barrier for interventions that are not related to behaviour like speech interventions
  • Does the health plan make it mandatory that your check in with your provider before going in for an intervention?
  • How much, if anything does the health plan stipulate that you have to pay alongside the coverage provider?

  Top Health Insurance Providers in the UK

With a keen eye on what to look out for when seeking health coverage for people struggling with autism, we went on to compile the best health coverage providers in the UK.

When it comes to picking something as important as health coverage, it is imperative that you take your time, irrespective of the size of the insurance company vying for your confidence.

As our list shows, the biggest are not necessarily the best

1.April UK

April UK rolls out a range of health insurance policies that provide both comprehensive and essential coverage. They are based throughout the UK, the Republic of Ireland and 30 other countries.

Their Private Medical Insurance Plan, by offering you a choice of comprehensive benefits and discount options, gives you the chance to tailor your own bespoke policy according to your needs and means.

Foundation cover offers you Full Impatient and Day Patient Care, with no overall annual limit on your coverage. You also have the option of ramping up your policy with add-ons such as psychiatric care, complementary medicine, worldwide travel, health cash, and an extended hospital list.

The Avalon Medical Cash plan offers you and your family routine coverage such as prescription drugs, seeing a specialist or an overnight stay at the hospital.


The fact that Health-On-Line policies are underwritten by AXA PPP Healthcare limited means that they come with over 60 years of experience in private health care coverage.

Health-On-Line adopts a modular approach to health insurance, allowing you to tailor your policy with modules that suit your budget and needs.

Their Private Health Insurance is built around an essential cover policy that caters to your in-patient and day-patient treatment for eligible medical conditions that arise after your start date. You then have the option of additional add-ons depending on what your needs are. There are 9 different additional options to choose from to create the private health policy that best suits your lifestyle.

The Family Health Insurance caters to your family’s health needs. You can add a spouse or partner on your cover, as well as your unmarried children up to the age of 24. Starting with the essential cover, you can tailor the many options to build a plan custom made for your family.

3.Western Provident Association

Western Provident Association has been providing quality health coverage for over a hundred years. Their plans include health coverage for companies, professionals, self-employed and families among others.

As a non-profit organisation the force behind their drive has always been customer value as opposed to shareholder value.

They have quite a few plans on offer:

Flexible Health Insurance which is ideal for families and individuals, allowing them to tailor their policies according to their needs by choosing from three different levels of cover.

XS Health Insurance that offers health coverage for children and students.

Active Health Insurance is aimed at individuals 55 and over with no upper age limit.

Health Care Cash Plan that covers much of the routine medical treatments as well as European cover

Dental Insurance Cover that offers two levels of dental cover, choice of dentist, and up to 250 pounds a year of dental treatment.

Corporate Health Finance aimed at companies with 3 or more employees and their families. Health coverage offers private medical insurance cover, dental insurance and a top-up cash plan.


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