Does Anthem Cover ABA Therapy in Maryland?

Understanding ABA Therapy Coverage with Anthem

Applied Behavior Analysis (ABA) therapy is a critical treatment for children with Autism Spectrum Disorder (ASD). For families in Maryland, confirming if your Anthem insurance plan covers ABA therapy is essential for accessing these necessary services. Here’s an overview of Anthem’s coverage for ABA therapy and how to navigate the process effectively.

Key Points to Consider:

• Policy Details: Anthem typically covers ABA therapy as part of their behavioral health services. Coverage specifics can vary based on the plan and state regulations. It is essential to review your plan details or contact Anthem customer service to confirm coverage.
• Eligibility and Enrollment: To qualify for ABA therapy coverage, a formal diagnosis of ASD from a qualified healthcare provider is required. The diagnosis must be documented, and a treatment plan must be recommended by a licensed ABA therapist.
• Authorization Requirements: Pre-authorization is typically required for ABA services under Anthem plans. This involves submitting a treatment plan and obtaining approval from Anthem before starting therapy to ensure that the services will be covered.
• Coverage Limits: Anthem may have specific limits on the number of therapy hours or sessions covered. These limits can vary, so it’s crucial to understand any restrictions under your specific insurance plan.

Steps to Verify Coverage:

• Contact Anthem: Reach out to Anthem’s customer service or visit their website to review specific coverage details for ABA therapy. This will help you understand the exact benefits and requirements.
• Consult Your ABA Provider: ABA therapy providers often have experience working with various insurance companies and can assist in verifying benefits and obtaining necessary authorizations.
• Document Communication: Keep detailed records of all communications with Anthem, including phone calls, emails, and any paperwork submitted or received. This documentation will be helpful if any issues arise or if there is a need for clarification.

How Move Up ABA Can Help

At Move Up ABA, we understand navigating insurance coverage can be challenging. We are committed to assisting you through this process to ensure your child receives the necessary ABA therapy. Our team will help you verify your benefits, obtain pre-authorization, and address any questions or concerns you may have about your Anthem coverage.

Conclusion

Understanding your Anthem coverage for ABA therapy is crucial to ensure your child receives the necessary support. By following these steps and utilizing available resources, you can navigate the insurance process more effectively and access valuable ABA therapy services in Maryland.

For more detailed information, you can visit the Anthem website and access specific plan documents or contact their customer service for personalized assistance.

If you have any more questions or need further assistance, feel free to reach out to us at Move Up ABA. We are here to help you every step of the way.