In my first post, I described Autism Spectrum Disorder (ASD) and how important it is to identify ASD early (you can read it here). Early identification is important so that Applied Behavior Analysis (ABA) Intervention can start as early as possible. If you would like to read all about ABA, see my second post here.
If you are a parent who has looked into the benefits of ABA, you have probably also noticed that it comes with a hefty price tag. The cost of receiving ABA is very expensive, and the reason for that is the cost of providing ABA is very expensive. There are the therapists, the supervisors, programming materials, standardized assessment tools, staff who do billing, staff who do scheduling, administrative staff, etc. The good news for families is that over the last decade legislation has passed requiring insurance to cover services for children with Autism Spectrum Disorders. Each state has different laws in place, and every year as new laws are voted in, the requirement for coverage changes. The important thing for families to know is they need to speak with their insurance company to find out about their coverage options.
The state of Colorado does have laws requiring insurance coverage for autism services, including Applied Behavior Analysis (ABA). Here is a summary regarding the current laws:
COLORADO LAW CRS 10-16-104
On July 1, 2010, Senate Bill 09-244 (now CRS 10-16-104) became effective in Colorado:
• For all children under the age of 19, requires most state-regulated group insurance policies to provide coverage for assessment, diagnosis, and treatment of autism spectrum disorder.
• On May 29, 2015, House Bill 15-1186 amended the CO Autism Law by increasing the age a child is able to begin receiving services from 0-6 years to 0-8 years and entitling the child to continue receiving services for a total of 3 full years. It also removed the waiting list for eligible children for the waiver program and allocated more funding to the Autism waiver program.
COLORADO SENATE BILL 15-015
On April 16, 2015, Senate Bill 15-015 included autism spectrum disorders in Colorado’s mental health parity law and repealed a provision that specifies that autism is not to be treated as a mental illness for purposes of health care coverage, thereby clarifying that health benefit plans issued in Colorado must include healthcare benefits for autism spectrum disorders that are no less restrictive than benefits available for a physical illness. This act takes effect on and applies to health benefit plans issued, delivered, or renewed on or after January 1, 2017.
Additionally, the act:
• Removes reference to any caps on the number of services or visits covered under a health benefit plan for the assessment, diagnosis, and treatment of autism spectrum disorders;
• Modifies the definitions of “autism spectrum disorders” and “treatment for autism spectrum disorders”; and
• Specifies that a nationally registered behavior technician (RBT) may provide direct services to a person with an autism spectrum disorder under the supervision of another autism services provider.
BENEFITS VERIFICATION
Behavior Frontiers offers free health care benefits verification for current and potential patients who have a diagnosis of Pervasive Developmental Disorder or Autism Spectrum Disorder. We can verify health care benefits for free when a patient’s family provides us with the needed information on our secure online parent portal at www.behaviorfrontiers.com. We will provide patients’ families with information regarding whether their health plan covers ABA benefits for autism, as well as information related to co-payments, deductibles, etc.
Contact Behavior Frontiers:
To learn more about our ABA training and treatment programs, visit our website.
To inquire about services for your child, please call our intake team at: 888-922-2843.
