Does Blue Cross Blue Shield Cover ABA Therapy?

Blue Cross Blue Shield's Coverage for ABA Therapy

Applied Behavioral Analysis (ABA) therapy has been shown to be an effective treatment for children with Autism Spectrum Disorder (ASD). However, the cost of ABA therapy can be prohibitive for many families.

That's where insurance coverage can make a significant difference. Blue Cross Blue Shield (BCBS) is one of the largest insurance providers in the United States, and their coverage for ABA therapy can make a big impact on families seeking treatment for their children.

What Does Blue Cross Blue Shield Cover?

BCBS offers coverage for ABA therapy, but the specifics of coverage depend on the state and plan. In general, BCBS will cover ABA therapy if it is deemed medically necessary.

This means that the therapy must be prescribed by a doctor and the child must have a diagnosis of ASD. BCBS may also require that the therapy be provided by a licensed or certified provider.

The amount of coverage provided by BCBS varies by plan and state. Some plans may have a limit on the number of therapy sessions covered, while others may cover an unlimited number of sessions. Some plans may cover the full cost of therapy, while others may require a copay or deductible.

It's important to note that BCBS coverage for ABA therapy may be subject to certain restrictions. For example, some plans may only cover ABA therapy for children up to a certain age. Additionally, BCBS may require periodic re-evaluations to ensure that the therapy is still medically necessary.

How to Get BCBS Coverage for ABA Therapy

To get coverage for ABA therapy through BCBS, you'll need to follow a few steps. First, you'll need to get a diagnosis of ASD from a doctor. Once you have a diagnosis, you can check your BCBS plan to see what type of coverage is available. You may need to get a referral from your doctor to see a provider who offers ABA therapy.

When you're ready to start therapy, make sure to choose a provider who is licensed or certified to provide ABA therapy. You'll also want to make sure that the provider is in-network with BCBS to ensure that you receive the maximum coverage possible.

Conclusion

BCBS offers coverage for ABA therapy, which can be a lifesaver for families seeking treatment for their children with ASD. The specifics of coverage depend on the plan and state, but in general, BCBS will cover ABA therapy if it is deemed medically necessary.

To get coverage, you'll need to get a diagnosis of ASD, check your BCBS plan, get a referral if necessary, and choose a licensed or certified provider. With BCBS coverage, families can access the therapy their children need to reach their full potential.