Ava's Law: Implications For Peachcare Members

Ava's Law, named after Ava Bullard of Lyons, GA, is a law that requires certain insurance companies regulated by Georgia law to provide Applied Behavior Analysis (ABA) therapy and other treatments for children diagnosed with autism. The law was signed by Governor Nathan Deal in April 2015 and became effective on July 1, 2015. It guarantees $30,000 of insurance coverage per year towards treatment for autism spectrum disorders for children under the age of six. On the other hand, PeachCare for Kids is a state children's insurance program in Georgia that provides comprehensive health benefits at little to no cost to qualifying families. It covers primary, preventive, specialist, dental, and vision care, as well as hospitalization, emergency room services, prescription medications, and mental health care. So, the question arises: does Ava's Law apply to PeachCare for Kids?

Ava's Law and insurance coverage

Ava's Law, named after Ava Bullard of Lyons, Georgia, is a landmark piece of legislation for children with autism in Georgia. Signed into law by Governor Nathan Deal in April 2015, it requires certain insurance companies regulated by Georgia law to provide Applied Behavior Analysis (ABA) therapy and other treatments for children diagnosed with autism. This law ensures that children under the age of six who have been diagnosed with autism or other terminal conditions receive $30,000 in annual insurance coverage for autism spectrum disorder treatments.

The law covers treatments such as physical therapy, occupational therapy, speech-language therapy, and marriage and family therapy. It also includes assessments, evaluations, and tests performed by licensed professionals to determine the presence of autism spectrum disorders. Insurance companies are mandated to provide coverage when deemed medically necessary by a licensed medical doctor or psychologist. Additionally, there are no limits on the number of therapy visits, except for ABA therapy.

While Ava's Law is a significant step forward, it has certain limitations. Currently, it only applies to specific insurance plans regulated in Georgia and covers children ages six and under, with a maximum benefit of $30,000 per year. However, even if a plan is not subject to this law, it may still provide coverage for ABA therapy and other autism treatments. It is important for families to check with their insurance plan to understand their specific coverage.

PeachCare for Kids is a separate health care program in Georgia that provides comprehensive health benefits at little to no cost to qualifying families. It is a state-funded children's insurance program, also known as S-CHIP, and is available to children who are under 19 years old, are U.S. citizens or eligible legal immigrants, have guardians who meet income requirements, and do not have current health care coverage or eligibility for Medicaid. While PeachCare for Kids does not specifically mention Ava's Law, it is possible that children enrolled in this program could receive benefits outlined in Ava's Law, depending on their specific insurance plan.

PeachCare eligibility criteria

PeachCare for Kids is a comprehensive health care program for uninsured children living in Georgia. It is a state children's insurance program, also known as S-CHIP, that provides comprehensive health benefits at little to no cost to qualifying families.

To be eligible for PeachCare for Kids, children must meet the following criteria:

• Be a resident of Georgia.
• Be a U.S. citizen or authorized immigrant.
• Not have current health care coverage or be eligible for Medicaid.
• Meet specific income requirements.

The income amounts are based on 247 percent of the Federal Poverty Guidelines and are updated annually. For example, a family of three can earn $43,029 a year, and a family of four can earn $51,818 a year.

To apply for PeachCare for Kids, you can visit Georgia Gateway online at www.gateway.ga.gov and select "Apply for Benefits." You can also call 1-877-427-3224 or 1-877-423-4746 for more information.

Ava's Law and autism treatment

Ava's Law is named for Ava Bullard of Lyons, Georgia, whose early autism treatment helped restore her speech. The law requires certain insurance companies regulated by Georgia law to provide Applied Behavior Analysis (ABA) and other treatments for children diagnosed with autism.

The law is a victory for children with autism in Georgia, who previously lacked access to effective treatments proven to help their behavioural disorder. It applies to state-funded insurance programs, not federal or self-funded. Children under six years old who are diagnosed with autism are guaranteed $30,000 of insurance coverage per year towards treatment. This includes commonly used interventions for autism spectrum disorders, such as physical therapy, occupational therapy, speech-language therapy, and marriage and family therapy.

Insurance coverage is provided when it is deemed medically necessary by a licensed medical doctor or psychologist. There are no limits to the number of therapy visits, except for ABA therapy. Government insurers, such as Medicaid, are exempt from providing coverage for behavioural health. Coverage begins following the next renewal period of the specific insurance policy.

While this law provides benefits to many children, it has its limitations. For example, it only requires coverage for children ages six and under and may have a maximum benefit of $30,000 per year. It is important to note that if your insurance plan is not subject to this law, it does not mean you don't have coverage. In fact, you might have even better coverage.

The passage of Ava's Law was a significant accomplishment, providing much-needed support for children with autism and their families in Georgia.

Ava's Law and age requirements

Ava's Law, named for Ava Bullard of Lyons, Georgia, was signed into law by Governor Nathan Deal in 2015. The law requires certain insurance companies regulated by Georgia law to provide Applied Behavior Analysis (ABA) and other treatments for children diagnosed with autism. The treatments include habilitative or rehabilitative services, psychiatric, psychological and counseling services, and speech, occupational and physical therapy.

The law currently applies only to children aged six and under, but there have been efforts to expand the age limit to include children up to 12 years old. The original law was championed by Ava's mother, Anna Bullard, who fought for five years to get autism coverage for children like her daughter, who experienced significant improvements in her condition after early-age treatment.

While Ava's Law provides valuable benefits, it has its limitations. In addition to the age restriction, there may be a maximum benefit of $30,000 per year, and it only applies to certain insurance plans regulated in Georgia. It's important to note that if a plan is not subject to this law, it doesn't necessarily mean there is no coverage for autism treatment. In fact, some plans may offer even better coverage.

PeachCare for Kids® is a health care program in Georgia that provides coverage for children who are under 19 years old, are U.S. citizens or eligible legal immigrants, have guardians who meet monthly and annual income levels, and do not have current health care coverage or eligibility for Medicaid. While PeachCare for Kids® is a separate program from Ava's Law, it demonstrates the state's commitment to ensuring access to healthcare for children, including those with autism.

Ava's Law and insurance plans

Ava's Law, named for Ava Bullard of Lyons, Georgia, is a landmark piece of legislation for children with autism in Georgia. Signed into law by Governor Nathan Deal in April 2015, it requires certain insurance companies regulated by Georgia law to provide Applied Behavior Analysis (ABA) therapy and other treatments for children diagnosed with autism. This law ensures that children under the age of six who have autism or other terminal conditions receive $30,000 in annual insurance coverage for autism spectrum disorder treatments.

The law covers treatments such as physical therapy, occupational therapy, speech-language therapy, and marriage and family therapy. It also includes assessments, evaluations, and tests performed by licensed professionals to determine the presence of an autism spectrum disorder. Insurance companies are mandated to provide coverage when deemed medically necessary by a licensed medical doctor or psychologist. While this law brings significant benefits, it has limitations. It currently only applies to specific insurance plans regulated in Georgia and covers children ages six and under, with a potential maximum benefit of $30,000 per year.

Now, let's discuss how Ava's Law intersects with PeachCare for Kids®, a comprehensive health care program for uninsured children in Georgia. PeachCare for Kids® is a state-funded children's insurance program that provides health benefits at little to no cost to eligible families. To qualify, families must meet specific criteria, including income requirements. While PeachCare for Kids® does not specify coverage for ABA therapy, it is a state-funded insurance program. Therefore, it is likely that Ava's Law applies to PeachCare for Kids®, providing ABA therapy coverage for children diagnosed with autism.

However, it is important to note that PeachCare for Kids® has its own set of eligibility criteria. To be eligible, children must be under 19 years old, be residents of Georgia, be U.S. citizens or authorized immigrants, and not have current health care coverage or be eligible for Medicaid. Additionally, their guardians must meet specific income levels. While Ava's Law expands access to ABA therapy for children with autism, it is essential to understand the specific requirements and limitations of both Ava's Law and PeachCare for Kids® to determine eligibility and coverage accurately.

In conclusion, Ava's Law is a groundbreaking piece of legislation that improves access to treatment for children with autism in Georgia. Its intersection with PeachCare for Kids® likely extends ABA therapy coverage to eligible children within the program. However, it is important to carefully review the specifics of both Ava's Law and PeachCare for Kids® to fully understand the scope of coverage and benefits provided.

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