California Law Now Covers PANDAS/PANS Treatment

California’s AB 2105: Insurance Coverage for PANDAS and PANS Treatments

If you live in California and have a child with PANDAS or PANS, there’s important news you may have missed. Assembly Bill 2105 (AB 2105) was signed into law on September 28, 2024, and went into effect on January 1, 2025.

This law now requires California-regulated health plans and insurance policies to cover the prophylaxis (preventive care), diagnosis, and treatment of Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS) and Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS).

Why Is This Important?

Many families have struggled for years to get insurance coverage for PANDAS/PANS evaluation and treatment. These conditions can cause sudden, severe changes in a child’s behavior and mental health, including:

• Anxiety

• OCD symptoms

• Tics or involuntary movements

• Emotional instability

• Aggression or rage episodes

• Food restriction

Previously, treatments—like antibiotics, immunomodulatory therapies, and psychiatric support—were often not covered, leaving families to pay out-of-pocket or fight through lengthy appeals.

What Does AB 2105 Do?

As of January 1, 2025, health plans regulated by California law are required to cover:
✅ Prophylactic care to help prevent flare-ups
✅ Diagnostic testing and evaluations
✅ Medically necessary treatment for PANDAS and PANS

This change can reduce out-of-pocket costs, improve access to appropriate care, and save families the stress of battling insurers for medically necessary treatments.

What Should Parents Do?

✔️ Review your health plan: Check whether your insurance is regulated in California (most fully insured plans are).
✔️ Talk to your child’s doctor: Make sure their treatment plan is well documented.
✔️ Keep records: Maintain documentation of any past denials or expenses—this may help with new coverage rules.
✔️ Contact your insurer: Ask about how they are implementing AB 2105 and any new procedures for claims.

Learn More

For more details on the bill and its language:

• California Legislative Information – AB-2105 Bill Text

• PANDAS Network – Insurance Coverage Resources

• California Department of Managed Health Care (for questions about California-regulated health plans)

Final Thoughts

AB 2105 is a big step forward for California families managing PANDAS and PANS. It recognizes these conditions as serious medical issues requiring real treatment—and makes insurance coverage mandatory rather than optional.

If you’ve faced challenges getting your child’s care covered in the past, know that new protections are now in place. And as always, consider talking with your healthcare team or an insurance advocate to understand how this law can help you.