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Insurance

ABA Therapy in Missouri That Accepts Insurance

If you are considering ABA therapy for your child, you may have questions such as: Does insurance pay for ABA therapy? Is ABA therapy covered by Medicaid? We can answer these questions and help your child get the treatment they need. 

Atlas Autism Health is a Missouri ABA clinic that accepts insurance and Medicaid.

The emotional, psychological and financial effects of an autism spectrum disorder (ASD) diagnosis can be far-reaching. However, Applied Behavior Analysis (ABA) therapy has the transformative potential to help children with ASD become more independent and lead fulfilling lives. In fact, ABA therapy is the leading treatment for children with ASD.

Does Missouri Medicaid Cover ABA Therapy? 

Because ABA therapy is recognized as an evidence-based treatment that can significantly improve the lives of individuals with autism, Medicaid covers the full cost of ABA therapy through MO HealthNet. 

To be eligible for coverage, your child must meet specific criteria. First, a health care professional, such as a child psychologist or neurologist, must diagnose your child with ASD. While children can receive Medicaid coverage until they're 21, Missouri's Medicaid program prioritizes early intervention services, as early diagnosis and treatment can greatly enhance outcomes. 

Medicaid also requires a comprehensive assessment and an individualized treatment plan from a qualified professional in addition to a professional diagnosis. 

Does Insurance Pay for ABA Therapy in Missouri? 

Missouri law mandates that certain insurance plans cover ABA therapy. However, the extent of coverage can vary significantly, with many providers covering only a portion of the costs. 

The law applies to: 

  • Fully insured large group plans offered by employers with 50 or more employees. 
  • Fully insured small group plans offered by employers with one to 49 employees.
  • Individual non-grandfathered plans that comply with the Affordable Care Act (ACA) regulations. 
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Atlas can help you navigate your coverage and also recommend other financing options if your provider does not offer full coverage.

If you purchased your insurance before the ACA was enacted, your provider must offer you the option to purchase coverage for autism treatment. Insurance plans typically categorize ABA therapy as rehabilitative or therapeutic care and cover various ABA-related services, including diagnosis, psychological care and therapeutic interventions. Receive Quality Care at Atlas Atlas is enrolled in the Medicaid program, allowing us to offer therapy covered by Medicaid. Our Board Certified Behavior Analysts (BCBAs) provide comprehensive assessments and individualized treatment plans with specific goals and measurable outcomes that you can submit for coverage consideration. In addition to accepting Medicaid, we also work with various insurance providers to help your child access the treatment they need. We accept: 

  • Healthy Blue
  • UnitedHealth Group/Optum
  • UMR
  • Anthem Blue Cross Blue Shield MO
  • Blue Cross Blue Shield KC
  • Sunflower Health Plan
  • Cigna/Evernorth

Get Started With ABA Therapy at Atlas

Atlas Autism Health offers center-based ABA therapy for children aged two to six. As experts in early intervention ABA therapy, we tailor our treatment to offer individualized care, ensuring your child flourishes during the critical learning period of preschool. Get started with ABA therapy by filling out our online form. Our friendly team is available to offer more information about our approach and can assist you in navigating financing options.

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Getting Started

Category of questions on ABA

What is Applied Behavior Analysis (ABA)?

Applied Behavior Analysis (ABA), which is based on the science of learning and behavior, uses a systematic approach to helping your child develop and learn.  Principles of ABA can be applied in many areas to help your child, such as (but not limited to) increasing language and communication, improving social and play skills, increasing adaptive skills such as toileting, dressing and feeding, and reducing unwanted behaviors such as tantrums, aggression, or other dangerous behaviors.

There are many strategies that fall under the ABA umbrella, such as Natural Environment Teaching, Discrete Trial Training, Early Start Denver Model, and Pivotal Response Training.  At Atlas, we focus on naturalistic, play-based ABA and will individualize the strategies and approach we use for your child based on his/her needs.

Who recommends ABA?

ABA is recommended and endorsed as an effective intervention for ASD by the US Surgeon General, the National Institute of Mental Health, the National Institute of Child Health and Human Development, the National Research Council, the American Academy of Pediatrics, American Academy of Child and Adolescent Psychiatry, and the American Academy of Neurology, among other national medical organizations and associations.

Is ABA effective?

ABA-based intervention has proven to be the only gold standard therapy for children with autism spectrum disorder. ABA is considered an evidence-based best-practice treatment by the U.S. Surgeon General and the American Psychological Association.

How much ABA is enough?

The Council of Autism Service Providers' practice guidelines advise that children who are under 3 years of age with an ASD diagnosis have greatest outcomes with 25-40 hours a week, and children who are approaching the age of 3 have greatest outcomes with 30 or more hours a week.

When a child is recommended to receive comprehensive ABA treatment (25 hours or more), it is common for this to be challenging for parents to commit to. This is understandable, but research shows that time spent away from therapy can lead to greater skill deficits or behavioral challenges. Receiving intensive services as soon as recommended will give the child a greater chance at reducing the amount of services and time spent in therapies as the child gets older.

A wide body of research shows that intensive ABA services as early as possible leads to the most effective clinical outcomes for children with autism.

How much does this cost?

ABA therapy is considered a medically necessary treatment for individuals with autism spectrum disorder. This means that insurance providers are required to cover the cost of ABA therapy to some extent. However, the amount of coverage can vary widely. 

Medicaid covers the full cost of ABA therapy, while commercial insurance providers may only cover a portion of the cost (require a co-pay). Some insurance providers may limit the number of ABA therapy sessions that are covered each year. It is important to check with your insurance provider to understand what your coverage includes.  If your insurance provider does not cover the full cost of ABA therapy, there may be other options available to help you afford this important therapy.

Atlas is here to help you navigate your insurance and understand your coverage.