Amerigroup is a health insurance provider that offers coverage for Applied Behavior Analysis (ABA) therapy for children with autism spectrum disorder (ASD).
ABA therapy is an evidence-based treatment that can help children with autism improve their social, communication, and behavioral skills.
In this article, we'll discuss Amerigroup's coverage for ABA therapy in detail, including the eligibility criteria, coverage limits, and reimbursement process.
To qualify for ABA therapy coverage under Amerigroup, the child must have a diagnosis of ASD. The diagnosis must be made by a qualified healthcare professional, such as a licensed psychologist, psychiatrist, or developmental pediatrician.
The child's diagnosis must also meet the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
Amerigroup's coverage for ABA therapy varies depending on the plan and state. However, in general, the coverage includes:
The coverage limits for ABA therapy may include the number of hours per week, the maximum number of sessions per year, and the age limit for coverage. For example, some plans may cover up to 40 hours of ABA therapy per week, while others may have a limit of 20 hours per week.
Some plans may also have a maximum number of sessions per year, such as 120 sessions per year. The age limit for coverage may vary by state and plan, but it is typically up to age 21.
To receive reimbursement for ABA therapy, Amerigroup members must follow the following process:
Amerigroup's coverage for ABA therapy can provide much-needed support for families of children with ASD. By understanding the eligibility criteria, coverage limits, and reimbursement process, families can make informed decisions about their child's healthcare.
If you are an Amerigroup member and have a child with ASD, talk to your healthcare provider about the benefits of ABA therapy and how to obtain coverage.