[heading]Medicaid Coverage for Autism Services (ABA)[/heading]

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about medicaid insurance

and contact us info if you have any questions

Have questions about Medicaid?

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Or call us at 855-295-3276

[heading]Does Medi-Cal Cover Autism Therapy Services?[/heading]

Yes. As of July 1, 2012,  health insurance policies in California are required to provide benefits for specified conditions, including autism. For more information, read California’s Senate Bill, SB 946, about autism insurance law.

Note that while Medi-Cal provides coverage for ABA therapy, autism service providers are not required to accept any specific insurance providers. At ALP, however, we do accept Medi-Cal insurance.

[heading]If I have Medi-Cal, What Services are Covered with Autism Learning Partners?[/heading]

By law, your California insurance must provide Behavioral Health Treatment options, such as Applied Behavior Analysis (ABA). California State Senate Bill 946 defines “Behavioral Health Treatment” as “professional services and treatment programs, including applied behavior analysis and evidence-based behavior intervention programs, that develop or restore, to the maximum extent practicable, the functioning of an individual with pervasive developmental disorder or autism” and meet the following:

  • The child is diagnosed and prescribed a treatment plan from a licensed physician or psychologist
  • This treatment plan is implemented by a qualified autism service provider (such as ALP)
[heading]Let Us Help with Insurance[/heading]

Figuring out insurance and payment details can often feel overwhelming, and we realize your time is better spent focusing on the health of your family. Simply fill out this insurance form and we’ll be in touch with the help you need.

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Frequently Asked Insurance Questions

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Your patient responsibility portion depends on your insurance coverage. During the Intake process, Autism Learning Partners staff will verify the insurance information you provide as well as the copayment, coinsurance, and deductible related to your plan and provide this information to you. Your patient responsibility portion will be charged or billed to you after your insurance adjudicates your claim to ensure the correct amount. Please contact your insurancecompany or refer to your benefit plan for more information about what your out-of-pocket costs may be related to your care.

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Autism Learning Partners will not initially charge your card for patient responsibility if you have a secondary insurance on file. We will bill your secondary insurance for any outstanding balance, following your primary. You will be billed for any patient responsibility balance remaining after all insurance plans adjudicate your claims. Please note: if you have recently added secondary insurance to your coverage or you did not list a secondary insurance during your intake process please let an ALP staff member know so we can verify your coverage and add it to our system.

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Different insurance plans offer different coverage for ABA services and other behavioral health treatments. Some medical plans are governed by state law while others are governed by federal law.  In order to know what services are covered by your insurance plan, we must know what insurance plan you subscribe to.

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[heading]Let’s Talk[/heading]