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New Benefit Enhancement Includes Autism Coverage

January 1, 2010

In addition to the medical coverage provided to all covered children, Blue Cross and Blue Shield of Oklahoma is adding coverage to treat specific types of autism disorders as specified in member contracts. This benefit will apply to fully-insured HMO and PPO group health plans. Coverage will be effective for new groups beginning January 1, 2010. Existing group coverage will be effective at group renewal dates on or after January 1, 2010. Self-funded employer groups may elect to include this new benefit in their health plans.

This new benefit will cover children under six years of age for the following Autism Spectrum disorders:

  • Autistic Disorder (Childhood Autism, Infantile Psychosis and Kanner's Syndrome)
  • Childhood Disintegrative Disorder (Heller's Syndrome)
  • Rhett's Syndrome
  • Specified Pervasive Developmental Disorders (Asperger's Disorder, Atypical Childhood Psychosis and Borderline Psychosis of Childhood)

Benefits are limited to $25,000 per Benefit Period and $75,000 lifetime maximum per subscriber.

For more information, contact the Provider Inquiry Unit at 1-800-496-5774 or call the number on the back of the members ID card.

Note: This is not a contract and is only a brief description of some of the plan benefits. This information is not intended nor does it modify the terms of any agreement in any way. It is intended as a source of general information only.



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