Understanding Autism Research and How to Use it to Advocate for Your Child

BY: Hanna Rue, PhD, BCBA-D

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InformaciĆ³n general sobre el autismo

BY: Angela Montes

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The Premack Principle (or First: Then Rule), A Positive Reinforcement Strategy

BY: Chisato Komatsu

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KNOW YOUR PLAN

FIRST… Before anything else, the first step to getting coverage is identifying the type of insurance plan you have and understanding how it is regulated.

Even if your state has not implemented an Autism Insurance Law, you may have coverage through your private insurance. Insurance plans fall into two categories: 

Under Fully Funded Plans, the employer and/or employee pays the premiums.  Fully Funded Plans are required to follow all state and federal mandates that exist where the plan is purchased, so if there is a state law in place to support ABA services, insurance must cover it.  

Under Self-Funded Plans, the employer sets up a fund to pay claims as they are received (instead of paying premiums for group insurance like Fully Funded Plans). These plans are not required to follow state mandates, but can elect to cover ABA.  What type of plan do you have? You can’t tell by looking at your insurance card—the quickest way to find out is to call your employer’s HR department or insurance company’s customer care line.

QUICK TIP:

Call your insurance company and find out if ABA is a covered benefit. (The insurance company may ask you to call another phone number or transfer you to another department for MENTAL/BEHAVIORAL HEALTH benefits.)