Yes. Amerigroup, a health insurance provider, covers most costs associated with ABA therapy in certain states and under specific conditions. Coverage is typically provided for children with a formal diagnosis of ASD. The diagnosis must meet the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and be made by a qualified healthcare professional such as a licensed psychologist, psychiatrist, or developmental pediatrician.
Applied Behavior Analysis (ABA) therapy is a widely recognized treatment for individuals with autism spectrum disorder (ASD) and other developmental disorders. It focuses on enhancing social, communication, and behavioral skills through evidence-based methods.
The specifics of Amerigroup's ABA therapy coverage can vary depending on the plan and the state. Generally, coverage includes:
Coverage limits may include the number of hours per week, the maximum number of sessions per year, and an age limit for coverage. These limits can differ from plan to plan, with some offering up to 40 hours of therapy per week, while others may have a limit of 20 hours.
Members seeking reimbursement for ABA therapy must follow these steps:
To find an ABA therapist who accepts Amerigroup insurance:
Understanding Amerigroup's coverage for ABA therapy is crucial for families navigating autism care. With its commitment to providing necessary treatments, Amerigroup offers essential support for enhancing the quality of life for individuals with ASD. By familiarizing themselves with coverage details and processes, families can access vital ABA therapy resources efficiently.
A: Preauthorization involves submitting the individual's diagnosis and treatment plan to Amerigroup for review. This is usually done by your healthcare provider.
A: If an individual requires both speech therapy and ABA therapy, these services may be covered under different parts of the insurance plan. It's important to consult with Amerigroup and your healthcare provider for specific coverage details.
Contact us today to discuss your insurance coverage options together.
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Level Ahead brings the excellence of a results-driven ABA intervention program to children on the autism spectrum, by providing quality in-home ABA therapy in Georgia and Nebraska.
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