How can I access ABA therapy for my child? For insurance to cover ABA therapy, your child must qualify for a diagnosis of Autism Spectrum Disorder. A letter from your clinician documenting the diagnosis and that ABA is medically necessary will be required at the time you apply for services.
What is a co-payment? This is the amount you pay at the time of service. A co-payment is billed to you for each visit, no matter the number of hours per session. If you have more than one session in a day (i.e., one in the morning and one in the afternoon), you will be billed a co-payment for each session.
What is a deductible? This is the amount you are responsible for paying before your insurance begins to cover your healthcare costs. Deductible payments are to be paid at the time of service until the balance has been met.
What is co-insurance? This is your share of the costs of a health care service. Co-insurance is a percentage of the total charge for the service.
What if there are changes to my insurance? You are responsible for knowing when there are changes to your insurance or coverage. If your insurance changes, please notify us immediately and before your next session so that we can make the appropriate changes to help you receive your maximum benefits. If your insurance company does not pay your claim, any rendered services that are not covered by your insurance will be billed directly to you after 45 days.
What if I can’t afford my child’s therapies? There may be other funding sources. Ask your BCBA about community grants available to support payment of medical expenses or treatment modalities. Some have been provided here for your convenience. Additionally, the organizations below may have updates to what they may provide. This is not an exhaustive list.
The Doug Flutie, Jr. Foundation for Autism, Inc. Family Grant Program
United Health Care Children’s Foundation
House of Possibilities – Respite Scholarship
Autism Speaks – More Financial Assistance Information
Where can I learn more about insurance funded ABA services? Massachusetts families may visit the Autism Insurance Resource Center’s website at https://www.disabilityinfo.org/arica/ to learn more about ABA services covered by insurance.