A Parent's Guide to Understanding Insurance For ABA Therapy

If your child has been diagnosed with Autism Spectrum Disorder, Applied Behavior Analysis will become a familiar term. It is an evidence-based approach using behavioral principles to help a child make the best of their potential. 

However, making the best of Applied Behavior Analysis requires you to look after several aspects. The therapist’s qualifications, learning approach, and your child’s progress could be some of them. Similarly, you need to consider the costs of the therapy. 

Fortunately, insurance can make ABA therapy services accessible for your child. It offsets the costs, helps access the care, and lowers stress on you. Insurance plans and coverages have changed lately. Yet, many companies have some exclusions and limitations, making it crucial to understand insurance. 

It is a good thing that you have reached here. In this post, we will walk you through understanding insurance so that you can avail of ABA therapy services easily. Read it till the end. 

Understanding The Costs of ABA Therapy 

Applied Behavior Analysis can require you to work with Board Certified Behavior Analysis and Registered Behavior Technicians. There are many other factors involved that impact the costs of ABA therapy collectively. Normally, the costs can be around $120 an hour or more, considering you are meeting up with a BCBA. In the coming section, let us discuss the other factors impacting the costs of ABA therapy: 

• Geographic Location 

The cost of ABA therapy can depend on the location. The therapists available in your region can impact the costs. Let us say your region has fewer professionals or centers for ABA, clearly the costs can be higher. Similarly, locations with higher living costs can have similar excessive prices.  

• Therapy Needed

The number of hours a therapist would need to dedicate can impact the overall costs of ABA therapy. Before beginning with the therapy, your child will undergo an evaluation.  The information gathered from this can help determine the strategies for ABA therapy. This can help determine the estimated cost.  Usually, it can take 20-40 hours a week.

• The Therapist 

Different types of therapists can play a role in ABA therapy and training of your child. The experience and qualifications of the therapists you will work with can affect the overall costs. For example, BCBAs can have higher costs, while behavior therapists might charge less. The number of services you avail can have a role to play, too. 

Insurance for Applied Behavior Analysis in Denver

By now, it is clear that Applied Behavior Analysis can cost a lot and thus require insurance. Initially, you need to check if your insurance plan covers Applied Behavior Analysis or ABA as a treatment for autism. However, that is just one of the things to be done, as you need to familiarize yourself with several terms. Here are some of them: 

• Deductibles: The term deductible in health insurance refers to the sum paid out of pocket before insurance plans begin to cover your services. Let us say you have a deductible of $1,500. This will be the sum you will pay for the ABA therapy services on your own.

• Co-Insurance: Co-insurance refers to the sum you will be responsible for paying after meeting the deductible. It is common in health insurance and is presented as a fixed percentage.

• Co-Pays: This refers to the amount you must pay for the medical service, in this case, the ABA therapy. It can be presented as a cost-sharing between the insurance companies and you. The amount of co-pays can differ, depending on your health insurance plans. 

• Out-of-pocket maximums: This refers to the maximum amount you will pay for the healthcare service before the insurance company begins covering it. After reaching this limit, the insurance provider will pay the rest of the amount.

  
  

Understanding Colorado’s Autism Insurance Mandate  

If you are a parent in Colorado, availing ABA therapy services with insurance can become a breeze. In this section, we will talk about the autism insurance mandate for Colorado. 

Colorado’s Autism Insurance Mandate

Colorado’s Autism Insurance Mandate comes from SB 09-244, which can also be addressed as the Mental Health Parity and Addiction Equity Act. It is a Colorado law which needs health insurance providers to cover assessment and treatment for certain disorders, including autism. As a result, you can find it easy to access the necessary facilities for Autism Spectrum Disorder.

According to the insurance mandate, any health insurance after 1st July 2010 (issued or renewed) covers it all for autism treatment, from assessment to treatment. This includes Applied Behavior Analysis, Behavior Training, and Behavior Management.  Additionally, speech therapy, occupational therapy, or physical therapy can be part of this. 

 

Understanding Insurance Options for Applied Behavior Analysis

ABA is an evidence-based therapy for Autism Spectrum Disorder. It is a proven approach that has brought notable changes in the behavior of children taking it. Fortunately, there are different insurance and funding plans for ABA therapy. Let us first discuss public funding for ABA therapy. Some plans available are Medicaid and Children’s Extensive Support Waiver. However, you need to keep in mind that:

• Learn about eligibility criteria and the application process.

• Inquire about the coverage provided, such as caps or restrictions.

Additionally, you can take advantage of different private insurance plans to leverage Applied Behavior Analysis. One thing to remember here is that the coverage for private health insurance can vary as per insurance plans. Similarly, others can have limitations on deductibles, co-payment, or covered hours. Here are a few things to keep in mind:

• Look out for coverage, pre-requirements, out-of-pocket costs, and more. 

• Inquire about the therapy settings and approved providers.

At BehaviorSpan, we offer extensive Applied Behavior Analysis services in Denver and Aurora. You can avail of our therapy services with a wide range of insurance providers. From Rocky Mountain Health Plans to United Healthcare, we accept many of these. If you want to learn more about our plans, enroll your child in our plans, or have any other queries, reach us today. 

How to Explore the Right Insurance Policies for Applied Behavior Analysis?

Here is a list of tips and tricks to navigate the insurance policies for ABA: 

• Understand the policy details carefully. 

• Learn about provider credentials and state laws.

• Maintain a record of communications and therapy sessions. 

• Learn about approval or preauthorization. 

• Learn about the key terms, including the ones you learned about earlier.

Conclusion 

Applied Behavior Analysis is a widely used intervention for individuals with an autism diagnosis. It helps children boost their positive behavior and lower the negative ones. However, you have to look after several aspects before availing of ABA therapy, including costs. Fortunately, you came across this post where you learned about navigating insurance for ABA therapy to simplify them.

Insurance is a necessary tool that lets you take advantage of ABA therapy. If you live in Colorado, you can take advantage of the insurance mandate for autism. You also learned about a few public funding and private insurance plans for ABA therapy. 

At BehaviorSpan, we are your team of  BCBAs and RCBs offering Applied Behavior Analysis. We have a team of trained and experienced professionals to aid your child navigate the behavioral challenges of Autism. We accept different insurances to make the best of ABA therapy plans. We provide center-based ABA therapy in Denver and Aurora.  Get in touch with our team today.