Does Insurance Cover ABA Therapy?

This is a question we are asked on a regular basis, and for good reason. Therapy of any kind can be expensive, and Applied Behavior Analysis (ABA) Therapy is no different. Often times the cost is the barrier preventing individuals from seeking treatment.

Before we dive in, it must be made clear that no staff employed by Neurospicy ABA are insurance experts, and we are not knowledgeable on individual insurance plans or constantly changing federal and state regulations. The only way to know for sure if you are covered is to contact your insurance provider.

The good news is that most insurance plans cover ABA Therapy. This is because of a federal mandate, as well as the Affordable Care Act (ACA), which requires insurance companies in all 50 states to provide coverage deemed medically necessary for autism treatments.

That said, those who have been diagnosed with Autism Spectrum Disorder (ASD) often require a variety of different types of support and therapy throughout their lifetime, meaning that navigating insurance coverage for ASD can prove tricky. Combined with the fact that coverages can range drastically from state to state as well as plan to plan, insurance coverage for ABA Therapy can vary from person to person.

The best advice would be to familiarize yourself with your plan, and call your provider for clarification on anything that doesn't make sense to you. The rules and laws can be drastically different from state to state, and the federal mandate only applies to certain plans.

As mentioned, no one enjoys navigating insurance plan coverages, and at times it seems like your provider is working against you with confusing industry jargon. Thankfully, Autism Speaks has put together a wonderful graphic (with links) as a great starting point for understanding benefits in regards to ABA Therapy being covered. Check it out here, and be sure to poke around on their site for other wonderful resources.

Do not let the price of therapy dissuade you from seeking help. Chances are your insurance provider will fully or partially cover the costs. Reach out to us at Neurospicy ABA if you have any questions; we'd love to help!