PRIVATE INSURANCE COMPANIES MUST NOW COVER DYSLEXIA TESTING IN NEW YORK

PRIVATE INSURANCE COMPANIES MUST NOW COVER DYSLEXIA TESTING IN NEW YORK 

On December 1, 2024, Governor Kathy Hochul signed the Dyslexia Diagnosis Access Act into law. (S5481A/A2898A). This law, the first of its kind in the United States, is designed to increase early diagnosis of dyslexia and other learning differences, such as attention deficit hyperactivity disorder (“A.D.H.D.”). (See The New York Times Private Insurers Must Cover Dyslexia Testing).  Starting January 1, 2025, private health insurers in New York are required to cover the costs of neuropsychological tests that diagnose dyslexia. The law does not require Medicaid-funded insurance plans to cover this testing.  

Dyslexia refers to a learning disorder affecting a student’s reading skills. It is often described by difficulties in phonological processing, decoding, reading fluency and spelling. (See NYSED Students with Disabilities Resulting from Dyslexia, Dysgraphia, and Dyscalculia).  In 2016, the International Dyslexia Association said that 15% to 20% of the population exhibits symptoms of dyslexia, such as slow or inaccurate reading, weak spelling or poor writing. (See MSN Hochul Signs Law Requiring Insurance Coverage for Dyslexia Exams).  Without proper testing, students are more likely to struggle in class, rely on social services and experience anxiety and depression. (Id.).  

The new law acknowledges that comprehensive neuropsychological tests are recognized as the most effective way to diagnose dyslexia. These tests: 1) assess how well children read; and 2) evaluate their learning needs. (Id.). 

The tests often cost in excess of $6,000, making these important evaluations inaccessible to many New York families.  In our experience, school districts do not always agree to pay for a neuropsychological evaluation and even when they do agree to pay for testing as an “Independent Educational Evaluation” (“IEE”), they cap the cost of the test, making it challenging to find an evaluator. 

With the signing of this law, “every insurance policy that provides coverage for physician services, medical, major medical or similar comprehensive-type coverage shall provide coverage for testing for suspected dyslexia”. (See The New York State Senate, Assembly Bill A2898A).