Understanding Insurance Coverage for Autism Therapy

Insurance Authorization Generally Takes One to Two Weeks

The cost of ABA therapy depends on your insurance coverage and how many hours of treatment your child will need.

We can estimate coverage amounts once we complete a psychological assessment and determine how many hours of ABA your child will need.

Deductibles, Copays, Coinsurance, and Out-of-Pocket Limits

You may have to meet a deductible, which is the amount you pay for covered health care services before your insurance plan starts to pay.

Some insurance plans have a coinsurance, which means you would be responsible for a set percentage of a bill until you reach an out-of-pocket limit, after which insurance would cover 100% of services.

Some insurance plans feature a copay, which is a set payment per day for services. Plans differ, but ultimately a family would make copayments until reaching an out-of-pocket limit, after which insurance would cover 100% of services.

Exclusion of Benefits and Limitations

If you see the term “exclusion of benefits,” it means the insurance plan does not cover a particular service and will not authorize or reimburse for any services. If your plan doesn’t cover ABA services, you may be able to work with your employer and/or insurance provider to add services.

Some plans have limitations on age ranges, hours/year, or total monetary caps (e.g., $30,000/year) for services. We can help you determine if your insurance plan has any limitations so you can plan accordingly.

Insurance Questions?

We’ll let you know if we are in-network with your insurance provider. We’re accepting new insurance providers all the time and we’ll do our best to help you navigate the process from start to finish.