Does Amerigroup Cover ABA Therapy?

If you're an Amerigroup member, you may be wondering whether or not your insurance plan covers ABA therapy. In this article, we will explore that question in depth.

Does Amerigroup cover ABA therapy?

The short answer is yes. Amerigroup does cover ABA therapy for its members. However, the extent of coverage may vary depending on your specific plan and location.

In general, ABA therapy is considered an essential health benefit under the Affordable Care Act (ACA). This means that insurance plans, including Amerigroup plans, are required to cover ABA therapy for children with ASD. However, there may be limitations and restrictions on coverage.

For example, some Amerigroup plans may limit the number of ABA therapy sessions per year or require prior authorization before beginning therapy.

Additionally, Amerigroup may only cover ABA therapy when it is deemed medically necessary by a healthcare provider. This means that if your child does not have a formal diagnosis of autism, or if they have a mild form of autism, Amerigroup may not cover ABA therapy.

It's important to note that even if ABA therapy is covered by your Amerigroup plan, you may still be responsible for some out-of-pocket costs. This may include copayments, deductibles, or coinsurance. The amount you are responsible for will depend on your specific plan and the provider you choose for ABA therapy.

If you are an Amerigroup member and are interested in pursuing ABA therapy for your child, the first step is to contact your healthcare provider.

They can help you determine whether or not ABA therapy is appropriate for your child and can provide guidance on how to access therapy services. Additionally, you can contact Amerigroup directly to learn more about your specific plan and coverage options.

Summary

In conclusion, Amerigroup does cover ABA therapy for its members. However, the extent of coverage may vary depending on your specific plan and location.

If you are interested in pursuing ABA therapy for your child, it's important to speak with your healthcare provider and contact Amerigroup to learn more about your coverage options. With the right guidance and support, you can help your child receive the therapy they need to thrive.