Instructional ABA Consultants Resources
At IABA, our services do not stop with therapy. We also work to provide the resources you need to help with insurance coverage.
ABA Insurance Coverage
IABA understands that managing or obtaining coverage for your child’s therapy is a big concern. We’re here to help you understand your benefits or obtain coverage if you do not currently have it.
Autism Mandate Laws
In the past 10 years, Autism Speaks and other advocates have worked hard, and as a result, 47 states have now passed Autism Mandate Laws. Each state has slight variances, but for the most part, these mandates guarantee insurance coverage for ABA therapy for families who have a fully insured, private insurance policy. Families that have a large employer self-funded policy are not included under this mandate however, and therefore are left without coverage for ABA therapy. Again, IABA is dedicated to helping families without coverage navigate alternative funding sources.
ASD Coverage for Your Child
If your family is left without coverage, there are a few options available. You can choose to purchase a separate insurance policy for your child that follows the mandate or you can advocate to your employer.
In Colorado: Medicaid insurance now pays for ABA therapy. Your child does not need to hold an autism diagnosis to receive ABA therapy; instead their pediatrician can prescribe ABA for a range of developmental delays and behavioral concerns.
In Illinois: IABA is working within the state of Illinois and encourages parents to advocate for ABA coverage on Medicaid insurance. Currently Illinois accepts HBS Funding through PUNS services to support children without any insurance coverage.
It is important to first call an ABA provider to ensure you ask the right questions before purchasing a policy to gain ABA coverage. If you would like to purchase a policy, you can visit www.getcoveredillinois.gov or you can contact a local insurance agent.
It can be very challenging and confusing to understand your insurance coverage for ABA therapy. Each insurance company has a completely different claim process for autism treatments.
In order to simplify the process for our clients, IABA Consultants has qualified insurance experts available to help you understand coverage and get you the maximum allowable benefits.
If necessary, ABA will work with your primary care physician and your insurance case manager in order to get any required authorizations or referrals. We will file claims to insurance companies, while adhering to the specifications of each insurance company. ABA will not bill the family until we have followed the progress of insurance payments and resolved any issues that have come up.
We will also coordinate any request from the insurance companies for an update on the child’s progress that has been made for a certain time frame.
Frequently Asked Questions
What is applied behavior analysis (ABA)?
Applied behavior analysis, ABA therapy, is the process of applying interventions based on the principles of the learning theory in order to improve social skills, facilitate language development, promote independent living skills and establish positive changes in behavior. ABA therapy is an effective way to decrease challenging behaviors, while simultaneously increasing positive behaviors.
What type of funding do you accept?
We will accept private insurance, private pay and Medicaid home waivers. We are in network with several different insurance companies, including BCBS, Aetna, Lifesynch, Cigna and Magellan. If your insurance is out of network, we can verify your coverage and find out if your insurance company will issue a single-case agreement.
Where do you provide services?
Instructional ABA Consultants provides both home-based ABA services and services in our clinics. An experienced BCBA (Board Certified Behavioral Analyst) will oversee the ABA therapy. We will customize an individualized plan for your child. Therapy will most likely be given several times a week, and the child’s progress will be monitored by both the program manager and by the behavior consultant monitor. In order to increase your child’s chance of success, parent training is necessary to help the parent be an active participant in the home-based therapy.
Do I need an autism diagnosis to receive ABA therapy?
If you are interested in receiving ABA therapy, insurance companies do require an autism diagnosis for services to be covered in Illinois. In Colorado, however, insurance does not require an autism diagnosis. Additionally, Medicaid Home-Based Waivers and private pay do not require an autism diagnosis for coverage.