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Real members of MyAutismTeam have posted questions and answers that support our community guidelines, and should not be taken as medical advice. Looking for the latest medically reviewed content by doctors and experts? Visit our resource section.

state ins that covers aba therapy

January 11, 2013
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Answer Summary

Members from across the country shared information about state health insurance coverage for ABA therapy, with 29 states having passed autism... Read more

Members from across the country shared information about state health insurance coverage for ABA therapy, with 29 states having passed autism laws requiring certain insurances to cover it, though many have caps, age limits, or exemptions for self-funded employer plans. Several members highlighted specific state programs, including Wisconsin's CLTS waiver covering three years of intensive ABA for children under eight, and Massachusetts' system where both MassHealth and school districts fund therapy, though coverage through MassHealth ends at age three and school-based services vary widely by district IEP agreements. A recurring theme was the frustration of navigating complex eligibility requirements, fighting school systems focused on budgets over children's needs, and the importance of connecting with resources like the Department of Developmental Services, grants, and understanding which insurance plans are actually subject to state mandates.

A MyAutismTeam Member

Thank you skybobsmom I def will...I take it not so good in CA.

February 18, 2013
A MyAutismTeam Member

Hii cjc you should look into Vermont law... As I understand it, it's the first state to mandate the Medicare (state health insurance) to cover aba, at first just to age 6, but now it's till 18 or 19, good luck.
Struggling in CA

February 18, 2013
A MyAutismTeam Member

I'll def check into that.Thanx so much.The school dept here is terrible seems they care more bout budget then the children.We have a second I.E.P review end of this month to see if he is progressing.If we dont come to an agreement i'm gonna gave to request emrgncy mediation.Just seems like no one wants to give my son the help hw needs.

January 12, 2013
A MyAutismTeam Member

Mass does, and it is also mandatory to have health insurance here, but if you cannot afford it you get put on Mass Health which is the state health insurance. Both of my kids have been on MassHealth from the start, and we pay not co pays or prescription costs at all. That includes specialists at Childrens as well.

My wife cannot work because she has to work with the kids, and I do not make much so I was able to drop my company health insurance and go on Masshealth as well with my wife and kids, and my wife and I pay a very low rate for co pany and scrips, it is something like $5 or so.

For the therapies it is payed for by the state technically but it goes through tthe school system and they actually pay it here.

January 12, 2013
A MyAutismTeam Member

Wisconsin has a clts waiver program that will cover 3y of intensive aba and continue after less intensive for as long as it is helping your child. To qualify the child must be under 8 when appling. Hasn't had more then a year of aba (think this is more to prevent being supplemental coverage) and there is ba 1y wait list.

January 12, 2013

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