Government mandates

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Several State and Federal legislative mandates on insurance coverage have passed in recent years and are in effect. If any changes happen, we will update the site to help you navigate the changes and determine whether they affect you and your insurance coverage.

The State of Wisconsin requires health insurance plans to cover Autism Spectrum Disorder, including Autism, Asperger's syndrome, and Pervasive Developmental Disorders not otherwise specified.

Our Q & A provides an overview of your health plan coverage for autism spectrum disorder treatments. It help you better understand your options as you discuss treatment with your child's health care provider.

If you have questions, contact the Customer Care Center at (800) 279-1301.

See our Q&A.

The State Dependent Mandate mirrors the Federal Dependent Mandate as it relates to the minimum required age for plans to cover dependents. A dependent is covered on the parent's policy until the dependent turns age 26, regardless of marital status.

Financial support from parents is no longer required, and full-time student status is no longer required, except in certain cases of students returning to school from military service.

See our Q&A

The Affordable Care Act (ACA) added new requirements for insurance coverage of preventive care for women and children.

It requires health insurers offering large group, small group and individual health insurance to provide benefits and prohibit cost-sharing for certain preventive services and screenings. Cost sharing is when both member and health plan are responsible for a portion of the cost of care and includes deductibles, copayments and co-insurance.

See more on preventive care

See more on Wisconsin state-mandated benefits.

See more on ACA Essential Health Benefits.