Self-funded Insurance Is Not Covering ABA Therapy For My Son. | MyAutismTeam

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Self-funded Insurance Is Not Covering ABA Therapy For My Son.
A MyAutismTeam Member asked a question 💭

Dear parents, my husband's self-funded insurance DOES NOT cover ABA. Our 3 year old was diagnosed with ASD and is recommended AT LEAST 10 hrs of ABA. Even the developmental pediatrician's diagnosis charges are not being covered. WE are quite devastated, and private pay looks like the only option. We are not eligible for medi-cal, and I am talking to regional center for further help. My questions are
1. My son is a regional center client (he just got 1.5 months of 1 hr weekly early intervention,… read more

posted April 19, 2016
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A MyAutismTeam Member

Hi, Sreeja.
Yes, self-funded plans are not under the same obligation to pay for ABA. That said, if your son is a client of the regional center, he is likely eligible for institutional deeming and Medi-Cal. My son receives Medi-Cal via this method. Parental income does not count against the child's eligibility; only any resources that are in the child's name would be counted. Then, once your son has Medi-Cal (which can take months), Medi-Cal is obligated to cover ABA.

In terms of purchasing a plan, I think you can also do this doing your child's birthday month. You may want to reach out to an insurance broker familiar with the needs of autism families.

If there is anything I can do, please feel free to get in touch.
Best,
Renee

posted April 19, 2016
A MyAutismTeam Member

Thank you

posted April 19, 2016
A MyAutismTeam Member

I have not done it myself but I was told by another Mom that there are organizations that often have grants. She told me she was given 5000 dollars and her and her husband make over 100000. I would google about grants in your area.

posted April 19, 2016

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