Does Blue Cross Blue Shield Cover ABA Therapy?

Blue Cross Blue Shield's ABA Therapy Coverage

If you're the parent or guardian of a child with autism, you may be familiar with Applied Behavior Analysis (ABA) therapy.

ABA therapy is a type of therapy that focuses on positive reinforcement to encourage desired behaviors and reduce undesired behaviors. This type of therapy has been shown to be effective for children with ASD, but it can be expensive.

That's why many parents and guardians wonder if their insurance, specifically Blue Cross Blue Shield, covers ABA therapy.

The answer is yes, in most cases. Blue Cross Blue Shield does cover ABA therapy, but the amount of coverage and requirements vary depending on the state and plan.

Not all Blue Cross Blue Shield plans cover ABA therapy, so it's best to check with your specific plan.

In states where ABA therapy is covered, Blue Cross Blue Shield typically requires that the therapy be provided by a licensed or certified provider. This means that the provider must meet certain qualifications and standards set by the state and the insurance company.

In addition, Blue Cross Blue Shield may require pre-authorization or pre-approval for ABA therapy. This means that you may need to get approval from the insurance company before starting therapy or before continuing therapy beyond a certain number of sessions.

The amount of coverage for ABA therapy also varies depending on the plan. Some plans may cover 100% of the cost of therapy, while others may cover a percentage of the cost.

There may also be limits on the number of sessions or the total cost of therapy that is covered. It's important to check with your plan to understand the specifics of your coverage.

If you're considering ABA therapy for your child, it's important to do your research and understand the costs and requirements of your insurance plan.

You may also want to consider working with a provider who has experience working with Blue Cross Blue Shield and can help you navigate the insurance process.

How To Get BCBS Coverage For ABA Therapy

To get Blue Cross Blue Shield (BCBS) to cover ABA therapy, you'll need to follow a few steps. First, check if your specific plan covers ABA therapy. You can do this by calling the customer service number on the back of your insurance card or checking your plan's coverage details online.

If your plan does cover ABA therapy, the next step is to find a licensed or certified provider who meets the qualifications set by BCBS and your state.

Many providers list their qualifications and experience on their websites, so it's worth doing some research ahead of time.

Once you've found a provider, you may need to get pre-authorization or pre-approval from BCBS before starting therapy. This means that you'll need to submit paperwork or documentation showing that your child needs ABA therapy and that it is medically necessary.

It's important to note that even if BCBS covers ABA therapy, there may be limits on the number of sessions or total cost of therapy that is covered. Be sure to understand the specifics of your coverage so that you can plan accordingly.

If you encounter any issues with getting BCBS to cover ABA therapy for your child, don't hesitate to reach out to customer service for assistance. They may be able to help you navigate the process and ensure that your child gets the care they need.

Summary

In conclusion, Blue Cross Blue Shield does cover ABA therapy in most states and plans. However, the amount of coverage and requirements vary, so it's important to check with your specific plan. With the right research and support, ABA therapy can be an effective and accessible treatment option for children with ASD and their families.