Insurances

Yes, ABA therapy is covered by insurance, but the specifics vary depending on your provider, plan, and state regulations. At Hearts ABA Services, we help you navigate your insurance policy guide you through the approval process.

Hearts ABA Services will handle the process of checking your insurance for details regarding coverage for ABA therapy. We’ll also guide you through the steps to obtain any necessary documentation.

ABA therapy is commonly covered by private insurance, employer-sponsored health plans, Medicaid (in many states), and TRICARE for military families. Hearts ABA Services can review your specific plan to determine your eligibility and benefits for ABA therapy and explain how state laws may affect your coverage.

Requirements generally include:

– A formal diagnosis of autism from a licensed professional

– A prescription or recommendation for ABA therapy

We handle all the paperwork and documentation required by your insurance company to ensure your child gets the therapy they need.

Coverage amounts vary depending on your insurance policy. Some plans cover the full cost, while others may require co-pays, deductibles, or have limits on therapy hours. Hearts ABA Services will work with your insurance provider to verify the specifics of your plan, including any out-of-pocket expenses, and explain them to you clearly.

Many insurance plans require pre-authorization to ensure ABA therapy is deemed medically necessary. Hearts ABA Services will handle the pre-authorization process for you. Our team will submit your child’s assessment and treatment plan directly to your insurance company to secure approval before therapy begins.

Insurance plans generally cover both.

In many states, including New York and Pennsylvania, Medicaid covers ABA therapy for children diagnosed with autism.

If your insurance denies coverage, Hearts ABA Services can assist you in appealing the decision. We will request a detailed explanation of the denial, gather additional documentation (such as a letter from your child’s pediatrician), and submit an appeal to your insurance provider. Our team will be by your side throughout the process to ensure every avenue is explored to secure the coverage your child needs.

At Hearts ABA Services, we are dedicated to simplifying the insurance process for you. Our team will:

– Verify your insurance benefits

– Submit all required documentation for pre-authorization and claims

– Provide detailed treatment plans reports requested by your insurer

– Work directly with your insurance provider to resolve any issues and maximize your coverage

We handle the complexities so you can focus on your child’s progress.

Yes, many families use Flexible Spending Accounts (FSA) or Health Savings Accounts (HSA) to cover ABA therapy costs. Hearts ABA Services can help you determine if your therapy expenses qualify and guide you through the process of using your FSA or HSA funds to pay for services.