Question 1

Do you accept my insurance?

Accepted Answer

Autism Behavioral Solutions currently accepts United, BlueCross BlueShield, Medicaid (Anthem, United and BlueCross BlueShield) as well as private pay. Most insurance covers ABA therapy however ABA services must be deemed medically necessary by your physician and insurance provider in order to be eligible for coverage.

Question 2

What does it mean for services to be "medically necessary?""

Accepted Answer

Medical necessity for ABA services is determined through an assessment of communicative, behavioral, social and self-care deficits and the impact of these deficits on the quality of life for the individual and their families. Educational deficits do not qualify as a medical necessity under current insurance regulations.

Question 3

How do I know if my insurance will cover ABA?

Accepted Answer

Most insurance plans are required by law to cover all or part of Applied Behavior Analysis services for children diagnosed with Autism.
In Virginia,
 • Diagnosis
 • Behavioral Health Treatment
 • Pharmacy Care
 • Psychiatric Care
 • Psychological Care
 • Therapeutic Care (e.g. services provided by licensed or certified speech language pathologists, occupational therapists, physical therapists or social workers)
 • Applied Behavior Analysis (ABA) 
are covered under the autism insurance bill HB 2467,HB 2577,(http://leg1.state.va.us/cgi-bin/legp504.exe?111+ful+CHAP0878+pdf) and SB 1031.(https://lis.virginia.gov/cgi-bin/legp604.exe?201+sum+SB1031)
 
Coverage of ABA for diagnosises outside of ASD can vary.

Insurance and Costs