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Lowdown On ABA Therapy And Insurance

A MyAutismTeam Member asked a question 💭
Fountain Valley, CA

Just curious how ABA therapy works in states requiring insurers to cover it. I work for the Feds and the federal health plan didn't cover ABA for years. OPM now "encouraged" to offer it, but they're not mandated. I've read plenty from my fellow federal employees with autistic children, and the handful of plans covering ABA are a joke. For anyone in MAT land receiving ABA through your medical plan, how is it working? Also , Autism Speaks should have a list of states mandating ABA coverage.

August 2, 2013
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A MyAutismTeam Member

I don't think they will pay for ABA in pur Florida school system. They encouraged me to send my daughter to an autism school if that is what we wanted. I know of no mandate that they have to do ABA therapy in a regular public school, however i did get it written in the IEP that her 1:1 aide be trained I the methods of ABA therapy with fading, they have to take behavioral classes before working with my daughter as said in the IEP. You definitely need to do your research and fight for everything you can. We have learned the laws protect our daughter and we make the IEP team adhere to the laws, it is a process and there is a fine line between fighting for your child or being thought as a trouble maker. We try to do everything we can to show we appreciate all the help our child receives but point out what would make her education more complete .

August 5, 2013
A MyAutismTeam Member

I do not know how it works in your state but here we do not use our insurance for it the school district pays for it we had it put in the IEP and the team agreed if was needed.

Our school district does provide it during the day as part of the school program but it was not enough so when we were at our daughters IEP meeting we brought it up. The director of special Ed in our district is part of the team and she gave us three hours a day after school from an outside agency which the district paid for.

I think part of it was that from dealing with us in the past they knew we would not give up or give in until we got what we needed.

My daughter is now in residential because she needed more than that, and when they gave us a hard time we got an advocate in which DDS paid for, and we also contacted our state representative and senator who really did not have power over the school to make them do it but they did scare them a little and put pressure on them. Finally they agreed and paid for that to, and that is very expensive ,

The reason I bring this up is that you have to fight for everything and you cannot take no for an answer. You also have to put the time in to know your laws and requirements in your state and hold everyone accountable and make them give give you what you need.

August 3, 2013
A MyAutismTeam Member

We have made sure our IEP covers all the needs of our daughter . PT,OT, ST, 1:1 aide, that is trained in the methodology of ABA. We make sure she has access to sensory breaks, brushing, etc. it is a lot of work and fighting to get the IEP the way it needs to be to benefit your child. We have read the Wright's law book back and forth, all their other books too. You have to know the law to get the members of the board to move an inch, but their also has to be a good working relationship and everything we have fought for we have provided research on the efficacy. Our daughter has an iron clad IEP because I wrote an 8 page addendum to be part of the IEP that we want and she needs to have done to help her progress, it is all laid out what the expectations are in black and white. I have had to learn so much through this journey, now my passion is helping others navigate this system. I have had the help of so many other parents and I feel the need to "pass it on".

August 15, 2013
A MyAutismTeam Member

Geez, good thing we can share info with each other. I'm really a skeptic now. We all must fight tooth and naill for our kids, Kindbof like being on the X Files, "Trust No One".

August 6, 2013
A MyAutismTeam Member

Our health insurance pays for a percentage of therapy. As far as the school goes, I thought it was a country wide law that "No child shall be left behind" meaning that ALL children deserve and need education and it is the governments responsibility to offer it. Now our school district offers special ed with physical therapy, occupational therapy, speech therapy and social work for each special needs child. I thought ALL school districts HAD to offer that all across the country. As far as ABA therapy.....it is not offered in the school district and it is considered a responsibility that the parents take on.....health insurance. I would look into that. Do not stress that the school district doesn't offer ABA therapy. If your child receives special education, you can request certain things at IEP time that would be considered ABA therapy. Just take good notes and be clear of what you want them to do to help your child. Do not mention ABA therapy, they may reject the whole idea. Just say that you want them to "adjust" the way they are doing things to better help your child. It's all in the interest of the child!!!

August 15, 2013

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