Michigan Autism Insurance

Autism Insurance Legislation

Michigan's Autism Insurance Reform legislation (PA 99 and PA 100 of 2012) went into effect on October 15, 2012. For-profit, commercial, HMO, and non-profit health insurance companies regulated by the state of Michigan are mandated to provide an autism benefit to its insured members covering services related to the diagnosis and treatment of autism spectrum disorders (ASD) through 18 years of age.

Self-funded insurance plans are regulated by Employee Retirement Income Security Act commonly referred to as ERISA through federal law. Self-funded insurance plans are not mandated to provide autism coverage.  However, if a self-insured company self-adopts an autism benefit whereby employees are offered autism coverage by the self-insured plan, then the self-insured company either directly or through its third party administrator (TPA) may submit reimbursement request(s) to cover the cost of the paid claims to the Autism Coverage Fund.


The Autism Coverage Fund was created to offset the cost of providing an autism benefit for health insurers, TPAs and self-insured companies. To participate in the Fund, paid claims must be for insured members who are residents of Michigan and who receive an ASD diagnosis and treatment by Michigan providers.

Medicaid & MIChild Autism Benefit

The Michigan Medicaid and MIChild Autism Benefit went into effect on April 1, 2013.This Autism Benefit provides children ages 18 months through 5 years old who have a medical diagnosis of Autism Spectrum Disorder (ASD) with Applied Behavior Analysis (ABA) services.ABA is a recommended service for children with Autism Spectrum Disorder. It has been researched for over 30 years and endorsed by the Surgeon General. ABA treatment can be used to address skills and behaviors relevant to children with Autism Spectrum Disorder.

Insurance Verification & Billing

You must provide proof of insurance prior to
your first visit. ACM works with and bills your insurance as a courtesy to you. Our intake staff will verify benefits and discuss with you, your coverage benefits and expectations for payment of deductibles, co-payment and co-insurance costs. It is your responsibility to know what your insurance coverage is and to track your visits. You are responsible for any payment of services that is not covered by your insurance. If your insurance does not cover a service you may have the option to pay privately. ACM will not change billing codes in an effort to receive payment for services that we have knowledge will not be covered otherwise.

Approved Autism Evaluation Centers and Board-certified Behavior Analysts

The following autism evaluation centers have been approved by Blue Cross Blue Shield of Michigan and Blue Care Network.

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Common Terms & Questions

What is a co-payment?
This is the amount you pay at the time of service. Co-payments are applied to each discipline you access.

What is a deductible?
This is the amount you are responsible for paying before your insurance begins to cover your healthcare costs.

What is co-insurance?
This is your share of the costs of a health care service. Co-insurance is a percentage of the total charge for the service.

Other Funding Sources
Ask staff about financial assistance and charity care available to support payment of medical expenses or treatment modalities.

Autism Centers of Michigan offers the highest quality of intensive, evidence-based behavioral treatment for children with autism spectrum and related disorders. ACM provides applied behavior analysis services to children and their families in their homes, in ACM clinics and school-sponsored programs throughout Michigan.

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Our mission is to improve the lives of individuals and families impacted by Autism.

Autism Centers of Michigan

Behavioral

Behavioral

Our team is dedicated to evidence based treatment. Our Board Certified Behavior Analysts create individual treatment plans based on current research. Our BCBAs determine treatment effectiveness based on data. Over time, treatment goals and the methods used to achieve these goals are refined to maximize effectiveness.

Education

Education

At the Autism Centers of Michigan we understand the desire of parents and caregivers to see their child succeed in a mainstream classroom with his or her peers. We are committed to not only teaching our clients academic skills, but life and social skills as well. We believe it is important to collaborate with parents, caregivers, teachers and other support members in our clients’ lives to ensure that they excel in every area.

Support

Support

We offer support for families that are affected by a loved one’s problem behavior. Problem behavior may range from a mild temper tantrum to severe destructive and aggressive behavior. The Autism Centers of Michigan uses a Functional Analysis of Problem Behavior to determine how to address the concern while teaching your loved one an appropriate alternative behavior.

Treatment

Treatment

Our treatments are individualized and our services are delivered one-on-one to ensure that our clients reach their full potential. All of our treatment plans are developed and overseen by Board Certified Behavior Analysts that have extensive experience delivering and overseeing ABA services. All of our services use current evidence-based programs proven to be effective in the research literature. For a more comprehensive look at what programs we offer please refer to our services page.

Regional Treatment Centers

Traverse City Center
1363 Douglas Drive Suite 104
Traverse City, MI 49696
Phone: 231-668-4909

Grand Rapids Center
5366 Eastern Ave SE
Kentwood, MI 49508
Phone: 616-608-3665

Administrative Office
1363 Douglas Drive Suite 104
Traverse City, MI 49696
Phone: 231-668-4909

Lansing Center
3887 Okemos Rd. Ste. A1
Okemos, MI 48864
Phone: 517-992-5333

Saginaw Center
5815 Bay Rd. Ste. 600
Saginaw, MI 48604
Phone: 989-941-3730

Central Fax
231-943-1334

Company Updates

June, 2016
Autism Centers of Michigan is pleased to announce the opening of our Grand Rapids Clinical Center on June 5th, 2017.
February, 2016
Autism Centers of Michigan is Going Green with Consumers Energy! The Saginaw center installed LED lighting throughout the offices. Not only is this good for the environment but it is improving patient care for clients sensitive to visual stimuli.

We are dedicated to serving Autism Communities across the Great State of Michigan and improving the lives of our clients.  We look forward to working with each of you and bringing you the best individualized services in the community!