Applied Behavior Analysis (ABA) therapy is a widely recognized and effective treatment for children with Autism Spectrum Disorder (ASD).
However, the cost of ABA therapy can be a significant burden for many families. For families who rely on Medicaid for healthcare coverage, it is important to know if ABA therapy is covered under their plan.
In this article, we will explore whether Medicaid covers ABA therapy in Maryland.
Does Medicaid Cover ABA Therapy in Maryland?
The short answer is yes, Medicaid does cover ABA therapy in Maryland. However, there are some limitations and requirements that families should be aware of.
First, ABA therapy is only covered for children under the age of 21 who have been diagnosed with ASD. The diagnosis must be made by a licensed physician or psychologist and must be based on the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM).
Second, ABA therapy must be deemed medically necessary by the child's primary care physician. This means that the therapy must be shown to be effective in treating the child's specific symptoms and must be recommended by a healthcare professional.
Finally, ABA therapy is subject to certain coverage limits. In Maryland, Medicaid covers up to 25 hours of ABA therapy per week for children under the age of 7, and up to 10 hours per week for children between the ages of 7 and 20. These limits may be adjusted based on the child's individual needs and the recommendation of their healthcare provider.
How to Access ABA Therapy Through Medicaid in Maryland
If you believe that your child may benefit from ABA therapy and you have Medicaid coverage in Maryland, the first step is to talk to your child's primary care physician. They can help you determine if ABA therapy is appropriate for your child and can provide a referral to a qualified provider.
Once you have a referral, you will need to find a provider who accepts Medicaid. The Maryland Department of Health maintains a list of Medicaid providers on their website, which can be a helpful resource.
It is also important to note that some providers may have a waiting list for ABA therapy services. You may need to be patient and persistent in order to find a provider who can meet your child's needs.
In conclusion, Medicaid does cover ABA therapy in Maryland for children with ASD who meet certain criteria. While there are some limitations and requirements, families who have Medicaid coverage can access this important therapy for their children. If you believe that your child may benefit from ABA therapy, talk to your child's primary care physician and explore your options for finding a qualified provider.