In most states, insurance companies – and the health plans they offer – are regulated by the state and are required to provide coverage for behavioral health services for individuals 21 years of age or under, including coverage for treatment of conditions such as autism.
This means that if your child or other family member has employer-sponsored or private healthcare insurance (commercial insurance) through a health plan, your insurance provider should help you cover the costs for appropriate and necessary treatment for autism and other similar conditions. Similarly, if you or your child qualify for healthcare coverage through a Medicaid plan, then ABA-Based Behavioral Health Treatment is a covered benefit with no out-of-pocket cost.
That’s the good news. But benefits and coverage can vary, and even if your health plan covers treatment for autism, you still need to explore and understand the details of the specific coverage you have. If you have healthcare coverage through your employer or through some other arrangement, it’s important that you fully understand the specific coverage provided by your health plan.
As part of our intake process, we can work with you to determine specific eligibility and benefits that will be applicable for your loved one. If there are deductibles or co-pays, we can assist with payment plans and other logistics that help easily facilitate payment for any portion of service fees for which you may have responsibility. You can connect with one of our Care Navigators by calling 833.227.3454 and we’ll be happy to guide you.