Where Michigan’s ABA Mandate Stops
The mandate is broad but not unlimited. These are the limits written into the statute itself.
Limits written into the statute
General exclusions still apply
Coverage can be subject to the policy’s other general exclusions and limitations, including coordination of benefits, participating provider requirements, restrictions on services provided by family or household members, utilization review and case management.
Prescription drugs
The section does not require prescription drug coverage unless the member is covered by a prescription drug plan.
One policy at a time
An insurer need not cover autism disorders under more than one of its policies for the same member. Where a member has more than one policy, benefits are subject to the statute’s limits when coordinating.
Short-term plans and exchange plans
Short-term or one-time limited duration policies of no longer than six months are excluded. A qualified health plan sold through the exchange need not cover beyond the essential health benefits.
Back to the ABA guide.
Where Michigan’s ABA Mandate Stops: short answers
What is a family or household member restriction?
The statute lets a plan restrict services provided by family or household members, so a parent generally cannot be paid as the provider.
Does the mandate require drug coverage?
Only if the member has a prescription drug plan. The section itself does not require one.
Does the mandate cover short-term medical plans?
No. Policies of no longer than six months described in section 2213b are excluded.
Where Michigan’s ABA Mandate Stops: not legal advice. Send us your renewal.
Where these details come from
The laws and rules named on this page link to the official text. This is general information, not legal advice, and rules change, so check the current text.
MCL 500.3406s, Insurance Code of 1956
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