November 1st marks the start of Open Enrollment for 2023. From November 1st, 2022 to January 15, 2023, you will have to purchase a child-only insurance plan covering ABA therapy. This process should not be a mystery, but for some, it can be challenging to navigate on their own for the first time.
Obtaining insurance coverage and funding for medically necessary therapies provides the opportunity for a child to reach their fullest potential. We understand each independent skill a child learns pushes them one step closer to independence.
Let’s start by looking at some of the estimates of current BCBS Marketplace Child-only plans, current prices may differ from these estimates.
Things you should keep in mind in addition to estimated prices:
- Your costs for insurance will depend on your expected household income
- You can apply in many different ways, including over the phone with an agent if that will make your first Open Enrollment experience feel less overwhelming
- You should have all your tax, income, employer, and household information on hand when you apply for coverage
Check out the Health Insurance Marketplace website to ensure you’re ready on enrollment day.
Does your self-funded plan exclude coverage for ABA therapy?
In many states, including Illinois & Texas, mandates guarantee coverage for families who have a “fully funded” insurance policy. What many don’t know, is large employer self-funded plans are not obligated to provide funding for ABA therapy. This means you should check if your self-funded plan has the option to elect to provide coverage. If you are having trouble with this let us know. Our team has been successful in helping families obtain coverage for services through their employers.
If you check your self-funded plan and it does exclude coverage, below are options you can pursue:
- Speak to your HR department or employer about covering ABA therapy. Be sure to tell them how imperative and medically necessary ABA is for your child and provide them with research articles proving the effectiveness of ABA. We would happily assist you in providing these resources.
- Autism Speaks has a Self-Funded Employer Toolkit with a wealth of information. You can access that tool kit here for more support.
Additional financial support and grants to explore
Various organizations are working to provide families with the additional funds needed to cover services. Applying for assistance can make copays or any other out-of-pocket expenses much easier. We put together a list of organizations offering this support for you.
- United Healthcare Children’s Foundation
- Chicago Autism Network
- The Autism Hero Project
- HFS Medicaid Health Insurance Premium Payment
- ARC Grant Handbook & ARC Illinois Grant Database
- C.A.R.E Family Grant Program
- ACT Today! Grants
If you need assistance with acquiring funding or purchasing a plan, always feel free to reach out. We are here to help you and your family gain access to the ABA therapy services your child needs.
We are committed to assisting families to pursue funding options for their children. Please do not hesitate to reach out to our New Client Liaison Department via email/phone, or feel free to schedule a caliendly appointment https://calendly.com/newclientinquiry/30min
For additional information about BPI and the services we offer, please visit us at https://bpiaba.com/
Written by: Patricia Myers