Does KanCare Cover ABA Therapy? A Kansas Medicaid Guide for Parents With Supportive Care ABA

Quick Summary

• KanCare may cover ABA therapy. Whether it does depends on your plan.
• Each managed care plan has its own steps for authorization.
• At Supportive Care ABA, at-home services start with an insurance check, which we help with.

We get insurance questions from families pretty much every week. So we put together the things we tend to tell parents first, all in one place.

Understanding Common Insurance Options: KanCare ABA Coverage

Does your child have an autism diagnosis? Then ABA through KanCare may be an option.

There's an assessment first. After that, a Board Certified Behavior Analyst (BCBA) writes up why your child needs the service.

We'll call your insurance provider before anything else, so nobody's left guessing about coverage.

Most parents we talk to started by searching for autism services KanCare families can use. What they found depended on their plan. Their child's treatment plan narrowed it down from there. 

How Kansas Medicaid ABA Works for Children Under 21

Kansas Medicaid ABA for kids goes through a federal benefit called EPSDT (Early and Periodic Screening, Diagnostic, and Treatment). It covers Medicaid members until they turn 21. If a clinician recommends a service and your child needs it, the plan can approve it. ABA can qualify.

So that's the federal rule. But your plan still gets to decide how it handles the request.

How Each KanCare Plan Might Handle ABA Requests

KanCare is run through managed care plans. Not sure which one your child has? It might be printed on the member card. Each plan uses different forms, and the deadlines won't always line up either.

Aetna Better Health Kansas ABA

Some families in Kansas are on Aetna Better Health of Kansas, and we get a lot of questions from them about ABA therapy Medicaid Kansas benefits. Aetna Better Health Kansas ABA requests usually start with the assessment. Prior authorization might come next.

Here's something parents don't always expect: the paperwork can make or break the timeline. We gather what the plan wants. Then, once you say okay, we send it.

Sunflower Health Plan ABA Therapy

Sunflower Health Plan ABA therapy requests run on each plan's forms and timelines, which can change based on every case.

That's why we check the plan's current requirements before starting.

UnitedHealthcare Community Plan ABA Coverage

UnitedHealthcare Community Plan of Kansas is the third plan. You'll likely need an assessment, a treatment plan, and prior authorization here as well.

If you see UnitedHealthcare on your child's card, tell us when you do intake. We'll call them and find out what they need.

Also worth mentioning: the plans' contracts with the state get updated from time to time. It's one reason we double-check everything before it goes out.

What Plans May Ask For Before ABA Starts

Every plan has its own list. That said, some things show up on almost all of them:

• An autism diagnosis (from a qualified clinician)
• A BCBA assessment that lays out recommended hours and goals
• A written treatment plan
• Prior authorization, which just means the plan says yes before services begin

We Verify Your Insurance at Supportive Care ABA

Insurance comes first for us at Supportive Care ABA. After that, it's the assessment, and then therapy can start. Here's a quick look at what each stage can look like:

1. Verify: Your KanCare plan and current benefits are reviewed. We call the plan and ask what it requires.

2. Assess: A BCBA meets your child at home for the assessment. We walk you through what to expect.

3. Submit: The assessment and treatment plan go to your plan for review. We prepare the paperwork and send it in.

4. Follow Up: The plan decides whether to approve the request. We check on the status and keep you posted.

5. Start: Therapy begins once approval comes through. We schedule sessions around your family’s routine.

You won't have to guess what's happening with your request. We'll call or email when there's news, and honestly, even when there isn't. Something on your mind halfway through? Just get in touch to ask us, and we’ll be there for support.

Tips for Parents Starting the KanCare ABA Process

• Put the member card somewhere you won't have to dig for it later.
• Any diagnosis report you're given, hang on to it. Old ones too.
• Each time you talk to the plan, note the person's name and the date.
• Write down any questions you want answers to before the call.
• Stuck with paperwork? Reach out to us for help.

Common Questions About KanCare and ABA

1. Will KanCare cover ABA for any child?

Not by default. Three things decide it: your child's diagnosis, medical necessity, and whatever your plan's rules say. We'll check those for you.

2. Does EPSDT apply to my child?

Yes, as long as your child is on Medicaid and hasn't turned 21 yet. When a clinician recommends a service that's medically necessary, the plan is allowed to approve it. How each plan goes about that is up to insurers.

3. Is a diagnosis needed before ABA can start?

In most cases, yes. Once that's done, we'll help with the next steps.

4. How long does insurance approval typically take?

There's no single answer because every plan's timing differs by case.

5. Can my child switch to Supportive Care ABA from another clinic?

You can definitely ask. First, we'll look at who's in your plan's network. After that, we can talk through your options together.

6. Can my child get ABA at home through KanCare?

It may be possible. That decision depends on your treatment plan and authorization. We'll confirm the details with your plan before services begin.

Want to Verify Your Insurance? We're Ready When You Are

We're happy to look over your insurance plan and explain your options in plain language. And we'd love to hear what you're hoping for your child, too.

Phone: (317) 563-0845

Email: info@supportivecareaba.com 

Prefer to do it online? Fill out the intake form, and our team will call you back.