PANDAS and PANS Insurance Policy by State

PANDAS/PANS treatment can be expensive but most states don’t require insurance to cover the expenses. Here are the states that do:

• Arkansas (2019)
  • Requires off label coverage of IVIG to treat PANS
• Delaware (August 2018)
  • Health insurance must cover treatment of PANS, including IVIG
• Illinois (July 2017, Charlie’s Law → August 2019)
  • Health insurance must cover treatment of PANS, including IVIG
  • Charlie’s Law mandated IVIG
• Indiana (January 2021)
  • Health insurance must cover treatment of PANS, including IVIG
• Kansas (January 2023)
  • Requires insurance coverage for PANS and PANDAS by the state health care benefits program and requires the state employee health care commission to submit an impact report on such coverage to the legislature
• Maryland (January 2021)
  • Health insurance must cover medically necessary diagnosis, evaluation, and treatment of PANS, including IVIG
• Massachusetts (October 2020)
  • Insurers must provide coverage for treatment of PANDAS and PANS including, but not limited to, the use of IVIG.
• Minnesota (January 2020)
  • Health plans must cover treatment of PANS. Treatments must be recommended by the insured’s licensed healthcare professional and include antibiotics, medication and behavioral therapies, plasma exchange, and IVIG
• New Hampshire (January 2020)
  • Requires coverage of PANS at parity with physical illness 
• Oregon (May 2023)
  • Requires health benefit plan and health care service contract coverage of PANDAS and PANS
• Rhode Island (January 2023)
  • Coverage must be provided for the treatment of PANDAS and PANS, including, but not limited to, the use of IVIG

Along with this there are many bills in progress at the moment