Catch 22: Autism Therapy & Insurance Coverage
One of the challenges facing a family that has a child (or children) with autism is the issue of insurance coverage for specific types of therapy – more specifically, ABA Therapy.
In the state of Virginia, for example, there is what some families call a Catch 22 situation.
Parents have to choose between public school or private school/homeschool – and what that would mean in terms of finances available.
Allow me to explain.
Say you have a child with Autism, and your child’s doctor prescribes 30+ hours of ABA [Applied Behavioral Analysis] Therapy.
Now, ABA Therapy is highly regarded as a great treatment for those on the Spectrum. It is also very expensive when paying out of pocket – at least $1,400 or more per month.
But here’s the issue that’s at hand – the 30+ hours per week. This means that the ABA Therapy takes up the same amount of time, if not more, than when a child is at school.
So the question that is brought up is, “where does the child go to school to obtain ABA Therapy?”
Currently it is either an approved program by the State (which the child has to go through a process of IEP’s and the parents have to fight for) – or the Parents have to go to a Private School or even Homeschool. Again, more IEP’s and possibly having an advocate.
If the Parents of an Autistic child go the Private or Homeschool route – then ABA therapy will only be paid by insurance programs IF the child is receiving therapy in a clinic or hospital.
Now you say, “What?”
Yes, a clinic or hospital specialized program. IF the child is attending a private school, and the people are administering ABA Therapy – Insurance will not cover it – even if the people that are applying the Therapy are certified by the state.
Plain and simple, really – the place where the money is being applied to is what the Insurance company pays attention to. Also they don’t have confirmation that the person who is applying the therapy is certified, etc…Continued on the next page