Does Medicaid Cover ABA Therapy in Maryland?

Understanding ABA Therapy Coverage with Medicaid

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

Key Points to Consider:

• Early and Periodic Screening, Diagnostic, and Treatment (EPSDT): Under the EPSDT benefit, Medicaid covers all medically necessary services for individuals under 21, including ABA therapy. This requirement is in place regardless of whether the service is explicitly mentioned in a state’s Medicaid plan.
• State-Specific Coverage: While Medicaid must cover ABA therapy as part of EPSDT, the specifics can vary by state. In Maryland, Medicaid provides coverage for ABA therapy, and it’s important to check the details with your local Medicaid office or healthcare provider.
• Eligibility and Enrollment: Medicaid eligibility is generally determined by income, but there are programs, such as the Katie Beckett State Plan Option, that allow children with disabilities to qualify based on their medical needs rather than family income.
• Authorization Requirements: Typically, Medicaid requires prior authorization for ABA services. This involves getting a referral from a qualified healthcare provider who can document the medical necessity of ABA therapy for the child.

Steps to Verify Coverage:

• Contact Medicaid: Reach out to your state’s Medicaid office or visit the Medicaid website to review specific coverage details for ABA therapy in Maryland. This will help you understand the exact benefits and requirements.
• Consult Your ABA Provider: ABA therapy providers often have experience working with Medicaid and can assist in verifying benefits and obtaining necessary authorizations.
• Document Communication: Keep detailed records of all communications with Medicaid, including phone calls, emails, and any paperwork submitted or received. This 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 Medicaid 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 Medicaid coverage.

Conclusion

Understanding your Medicaid 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 Medicaid 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.