Diagnostic and treatment services for children with ASD are generally available in New Mexico, and are funded by private insurance, public employee insurance, and Medicaid. To find out specifics of your insurance plan, consult your benefit handbook or talk to a customer service representative at the health plan. The links below will assist you in better understanding how insurance works for your loved one
The Autism Speaks NM page explains the insurance laws that were passed in 2009 and 2013. They guarantee coverage for individuals who have private insurance or public employee insurance.
The NM Health Insurance Exchange: The plans on the exchange offer coverage for ASD. Should your insurance come through a large self-funded (ERISA) employer, the insurance doesn't have to offer coverage for ASD. Individuals in those situations can approach the HR department of their employer and ask them to amend their coverage to include benefits for ASD, ask the employer to pay the costs of a child only policy on the NM Health Insurance Exchange, or privately purchase a child only policy.
For all questions about ASD therapies, please contact the Centennial Care MCO in which you are enrolled, and ask to speak directly to the assigned care coordinator.
What is NM Medicaid?
Medicaid provides health coverage to millions of Americans, including eligible low-income adults, children, pregnant women, elderly adults and people with disabilities. Medicaid is administered by states, according to federal requirements. The program is funded jointly by states and the federal government.
The NM Superintendent of Insurance: If you feel that you’ve been given inaccurate information by your insurer, or wish to pursue a complaint, OSI can assist you.
The Autism Programs' Family and Provider Resource Team is also happy to help you navigate complex insurance issues.