Does Insurance Cover ABA Therapy With Supportive Care in Missouri? What Parents Need to Know

You have a diagnosis, you know what kind of therapy to use… but how will you pay for it?

If this is the first time your family is navigating the world of ABA therapy (or if you have dealt with this before), the thought of figuring out insurance coverage can be difficult. We hear this weekly from the families we work with at Supportive Care ABA. The good news is we take care of insurance verification for you.

Throughout this article, we will discuss how autism insurance in Missouri works, how Supportive Care ABA makes getting access to the therapy you need easier, and ways to get started with minimal stress.

The Missouri Autism Insurance Mandate: Providing Families Security

All private health insurance plans issued in Missouri may provide coverage for autism diagnosis and ABA therapy. This provides some reassurance to families trying to provide services to children with confirmed autism diagnoses since they will likely qualify for insurance through ABA therapy.

Autism Insurance Mandate in Missouri: A Support System for Families

Missouri mandates that many private insurance companies provide group health plans to ensure treatment and diagnosis of ASD. This means that if you have a child diagnosed with autism, you may have a coverage option to help pay for their ABA therapy.

This is an important protection for families with children diagnosed with autism. In fact, for any children who have received a confirmed diagnosis of autism, ABA therapy may qualify as a covered benefit from your insurance company in Missouri.

As a Result of Missouri's Statute, the Following May be Provided in Your Plan:

Diagnosis evaluations about autism spectrum disorder, ABA therapy, and speech, occupational, and physical therapy for autism.

However, the mandate only applies to fully insured plans that fall under Missouri's jurisdiction and regulation. Therefore, if you work for a company that has a self-funded plan, your coverage will be different than the coverage of employees on a fully insured plan. If you do not know whether you qualify for coverage under Missouri's mandate, contact us to see if you are eligible before taking any other actions.

How Supportive Care ABA Handles Your Insurance, So You Don't Have To

When families first contact us, they often have many questions and not much time to get answers. That's why Supportive Care ABA will handle the insurance process from the moment you reach out with any questions.

We work with a wide range of both major commercial & Medicaid managed care insurance plans and will coordinate with your insurance provider directly on your behalf. Evidence-based therapy is essential to helping children reach new milestones via in-home ABA therapy, so we want to make sure insurance paperwork does not stop your child from receiving the support necessary.

Once you contact us, we will:

• Verify your benefits with your insurance company,
• Confirm if a prior authorization is required and manage that process for you,
• Submit your child's assessment report and treatment plan to your insurance company to help secure funding for services,
• Manage ongoing authorization renewals for continued services,
• Keep you updated and informed at each step of the process.

Medicaid ABA Therapy in Missouri: Find Support for Families Who Qualify With Us

Missouri Medicaid, known as MO HealthNet, can cover ABA therapy for eligible children with an autism spectrum disorder diagnosis. Medicaid ABA therapy in Missouri is a meaningful option for families who qualify, and Supportive Care ABA works with Medicaid families to help make the process as smooth as possible.

Getting started typically involves a formal autism diagnosis, a referral for ABA services, prior authorization from MO HealthNet or your managed care organization, and an initial assessment completed by a Board Certified Behavior Analyst (BCBA). Our clinical team manages these steps and communicates directly with your plan so nothing is missed and ABA therapy can start as soon as possible.

If you are unsure whether your child qualifies, reach out to us, and we will help you work through your options.

Understanding ABA Therapy Cost in Missouri

Without insurance, ABA therapy costs can add up quickly, since many children benefit from a significant number of therapy hours each week. This is exactly why insurance navigation matters so much.

MO HealthNet covers ABA therapy for children with an autism diagnosis. MO HealthNet ABA therapy is a great resource for qualifying families. Supportive Care ABA supports families with MO HealthNet to ensure that they receive maximum service from their health plans.

If you are unsure if your child qualifies to receive ABA therapy or have any other questions about the process and are interested in assistance, contact us. No family should miss out on services based on fear of the process being overwhelming.

The price of ABA therapy without insurance could be very high due to the number of therapy hours many children utilize every week. This is why insurance navigators are such a valuable service to families.

Families with coverage through our partner plans generally have their out-of-pocket expenses limited to deductibles or co-pays. This is a true representation of the power of correct insurance navigation, and it is why we take it seriously on behalf of each family we serve.

What Happens If You Are Denied or Delayed From A Claim

Even with autism insurance protections in place, your claim may still be denied or delayed.

Denials or delays may occur for many reasons, such as an incomplete submission, a gap in prior authorization, or missing progress reports required for renewal.

When a family that works with Supportive Care ABA encounters this issue, we will not leave the family to manage it on their own. Supportive Care will assist families through the appeals process by providing clinical documentation and contacting insurance directly. Families are entitled to pursue reimbursement for ABA therapy in Missouri, and we will help families achieve that.

ABA Therapy Coverage In States Outside Of Missouri

Supportive Care ABA works with families in multiple states, and each state has its own unique insurance requirements. If you live outside of Missouri or are considering relocating to Missouri, then we can assist you with understanding your options for coverage in Indiana, Kansas, Virginia, Georgia, North Carolina, and Oklahoma, as well as Missouri, Arizona, and South Carolina. Please look at the area map to find our staff.

Questions You Should Ask Your Insurance Company Before Contacting Us

When contacting Supportive Care ABA, it may also be helpful to first reach out to your insurance company to obtain the answer to a few questions that can help us quickly verify your benefits so we can help you get what you need.

• Does my current plan cover ABA therapy?
• Is my plan insured through Missouri state or self-funded ERISA?
• Do I need pre-approval for insurance coverage of ABA therapy?
• What are my deductibles or co-pays for mental health services?
• Which providers are considered authorized providers for my insurance?

If any of your questions seem too daunting to answer, call our team: (317) 563-0845.

Do You Want to Learn What Your Insurance Will Pay For?

No child should have to wait for treatment due to not having insurance coverage. Supportive Care ABA will confirm benefit coverage information with your insurance company, provide authorizations for services, and connect Missouri families with evidence-based ABA therapy for their child's success at home.

If you are a physician or specialist and want to refer your patient, you can submit a referral through our website or start an intake request form online.

To learn more, contact Supportive Care ABA or submit your contact information through our website over here, or start the intake process, and we will contact you.

Frequently Asked Questions

1. Is ABA therapy covered by my insurance in Missouri?

Many private insurance plans regulated in the state of MO provide coverage for medically necessary ABA therapy due to a child's autism diagnosis; however, your plan will ultimately determine eligibility.

2. Does MO HealthNet cover ABA therapy?

MO HealthNet does cover ABA therapy for qualifying children who have received an autism diagnosis for medically necessary therapy, provided the child meets the coverage requirements.

3. What do I need to begin using insurance for ABA therapy?

Most insurance plans will require an autism diagnosis from a physician, a BCBA assessment, and prior authorization before services begin.

4. How long will it take to get approval from my insurance?

Every insurance provider varies in the approval process timeline; however, Supportive Care ABA does everything we can to expedite the approval process while keeping families informed along the way.

5. Can Supportive Care ABA assist with the insurance process?

Yes! Supportive Care ABA verifies your benefits, manages the authorization process, submits all supporting documents to your insurance company, and assists with any appeals that may arise. You will be able to spend more time with your child and less time dealing with your insurance.