There have been some changes with Anthem and the treatment of Autism in the state of Indiana.
If you or member of your family is receiving benefits for services for the treatment of Pervasive development Disorder (PDD) and are currently covered with Anthem there are big changes.
This is based in part by the Law on the Individuals with Disabilities Education Act (IDEA), which requires public schools to address the needs of students with PPD by creating, an Individualized Education
Program for each student. The public schools system is suppose to be able to treat children suffering from PDD.
Anthem is not going to duplicate coverage that is available through the school system. There can always be exceptions. The services available through public schools are explained on the Indianapolis Department of Education website.
With any coverage there are steps to getting claims paid. All treating physicians are going to need to be involved. Investigate what programs are available through your schools. Then check with current treatments to see if there are any overlapping procedures. The overlapping procedures are going to be the areas of concerns. Calculate what the treatments are costing.
If your child is receiving 7 different therapies and only 2 of them are covered in the schools system then you only have to be concerned with the 2.
Also beware of Anthem’s appeal process. There could be situations where the claims are denied but then approved with a detailed appeal process with your Doctor.