Does CareSource Cover ABA Therapy?

Applied Behavior Analysis (ABA) therapy is a type of therapy that is often used to help children with autism spectrum disorder (ASD) learn new skills and behaviors. This therapy is known to be effective, but it can also be expensive. That's why many parents wonder if their insurance will cover the cost of ABA therapy. In this article, we will explore whether CareSource, a popular health insurance provider, covers ABA therapy.

What is CareSource?

CareSource is a nonprofit health insurance provider that offers coverage to individuals and families in Ohio, Indiana, Kentucky, West Virginia, and Georgia.

The company was founded in 1989 and has since grown to become one of the largest Medicaid managed care plans in the country. CareSource offers a variety of health insurance plans, including Medicaid, Medicare Advantage, and Marketplace plans.

Does CareSource Cover ABA Therapy?

The short answer is yes, CareSource does cover ABA therapy. However, the extent of coverage may vary depending on the plan you have. CareSource offers several different plans, and each plan has its own set of benefits and limitations.

If you have a CareSource Medicaid plan, ABA therapy is covered as a behavioral health service. This means that you will need a referral from your child's primary care physician, and the therapy will need to be provided by a licensed provider who is contracted with CareSource.

The number of therapy sessions that are covered may also be limited.

If you have a CareSource Marketplace plan, ABA therapy is covered as an essential health benefit.

This means that the therapy is covered at the same level as other medical services, and there are no limits on the number of therapy sessions that are covered. However, you may need to meet your plan's deductible before coverage kicks in.

How to Get ABA Therapy Covered by CareSource

If you believe that your child could benefit from ABA therapy, the first step is to talk to your child's primary care physician. They can help you determine if ABA therapy is the right choice for your child and can provide a referral if necessary.

Once you have a referral, you will need to find a licensed ABA provider who is contracted with CareSource. You can search for providers on the CareSource website or by calling the customer service number on the back of your insurance card.

It's important to note that ABA therapy can be expensive, and you may still be responsible for some out-of-pocket costs even if your insurance covers the therapy. However, many families find that the benefits of ABA therapy far outweigh the costs.