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Autism - Support Across the Spectrum Autism - Support Across the Spectrum

Just got our ABA approved through our private insurance

Posted by on May. 2, 2013 at 11:55 PM
  • 15 Replies

30 hours!!!!! Woohoo!!!!! The law changed in California in August and PPO insurance must cover autism services now, I'm one of the first people I know of to actually be starting treatment under the new requirements. My friends receiving ABA through state services are getting like 5-8 hours with kids more severe than mine. I'm so thrilled. We'll be responsible for a $15 co pay for every day of treatment which will end up being like 5k a year out of pocket, on top of the pediatric developmentalist that is only minimally covered, but hey, it's worth it to me.

by on May. 2, 2013 at 11:55 PM
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Replies (1-10):
mypbandj
by Jen on May. 3, 2013 at 12:07 AM
That's great!
Posted on CafeMom Mobile
TheLadyAmalthea
by Bronze Member on May. 3, 2013 at 12:39 AM

I just called my insurance company for the same reason yesterday. He is 5, so I feel he is a little late to the game. They cover 90% of the cost. I do not think they covered it a year ago. I'm sure they have just started doing it because of all the new laws. It's about time! So sometime this summer he will hopefully start!

darbyakeep45
by Darby on May. 3, 2013 at 7:18 AM

That is awesome mama!

Reina67
by Lisa on May. 3, 2013 at 8:45 AM
We started in August, my son was the 1st client i n Kern Co. Needless to say
The co.pany they contracted with was good at begining. It has since become a nightmare, I have had to have 3 therapists removed and 1supervisor. I am now trying to get him removed from this company. I hope you have better luck. Be very aware, ask questions how data is taken, if they leave binder in the home....read it!!!! Be very very involved.
dawncs
by Dawn on May. 3, 2013 at 11:18 AM

Congratulations!

Dawn


Group owner of Different Learners Support Group (http://www.cafemom.com/group/118648)

LaurieMomof4
by on May. 3, 2013 at 11:39 AM

Reina did your insurance company make you go through a certain provider? Ours didn't, we were able to go through the provider of our choice. We went with the one our doctors at UCLA recommended. We'll have a team of 3 therapists working with Vaughn throughout the week. The center we are using came highly recommended and I'm hoping that since we are not beholden to them in particular the care will be good. They are keeping a binder here in our house and I will definitely read it day to day. They'll be working with him here as well as at his private school when he starts there in August. 


Quoting Reina67:

We started in August, my son was the 1st client i n Kern Co. Needless to say
The co.pany they contracted with was good at begining. It has since become a nightmare, I have had to have 3 therapists removed and 1supervisor. I am now trying to get him removed from this company. I hope you have better luck. Be very aware, ask questions how data is taken, if they leave binder in the home....read it!!!! Be very very involved.



AMom29
by Bronze Member on May. 3, 2013 at 2:03 PM

 That's awesome!

I'm still riding the goat rodeo here.  Ugh.

KatyTylersMom
by on May. 3, 2013 at 3:24 PM

Yes!  My son will be aged out of RCOC (regional center of Orange Co.) in June and our insurance will be covering his ABA.  No such luck on the low copayments though!!! Ours will run us $35 per session (regardless of session length) so that'll be $8,000 a year in copayments for ABA alone.  Oh and haha jokes on us b/c copays cannot be applied to our out-of-pocket maximums... OH CIGNA YOU CRACK ME UP!

JTMOM422
by Brenda on May. 3, 2013 at 9:21 PM

Way to go. I know you are excited 

LaurieMomof4
by on May. 4, 2013 at 11:21 AM

How old is your son? Why is he aging out of RCOC? Do you mean early intervention? They still should provide services if you have a diagnosis. I know they are trying to transition people over to private insurance but what happens if you can't afford the 8k in copays???


Quoting KatyTylersMom:

Yes!  My son will be aged out of RCOC (regional center of Orange Co.) in June and our insurance will be covering his ABA.  No such luck on the low copayments though!!! Ours will run us $35 per session (regardless of session length) so that'll be $8,000 a year in copayments for ABA alone.  Oh and haha jokes on us b/c copays cannot be applied to our out-of-pocket maximums... OH CIGNA YOU CRACK ME UP!



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