Applied Behavioral Analysis (ABA) is the gold standard in autism treatment. ABA therapy helps children overcome challenging symptoms, connect with others, and achieve independence. After your child is officially diagnosed with ASD by a healthcare professional, you can enroll them in ABA therapy as early as 18 months old.
But wait – how much does ABA cost?
With insurance, the cost of ABA therapy will depend entirely on your coverage and benefits. But we can say that you should expect to meet your Out of Pocket Maximum each year if you enroll in ABA therapy.
Without insurance, these services are much more expensive: the typical rates for ABA therapy without insurance can exceed $75 per hour.
Is ABA Therapy Worth the Cost?
ABA therapy is a significant time and financial commitment, so it’s perfectly natural to wonder whether it’s worth the cost.
A substantial amount of research has gone into measuring the effectiveness of ABA therapy for autism spectrum disorder. Studies have consistently concluded that ABA is moderately-to-highly effective for improving the long-term development of children with autism.
Of course, no treatment works for everyone 100% of the time – this is the case for any diagnosis, from autism to arthritis. ABA may not work for every family. But, for many families, the results of ABA therapy are life-changing and worth every penny because they were able to see their child communicate more effectively, socialize with others, gain daily living skills, and reach a level of academic performance they may not have achieved otherwise.
The lifelong benefits your child could gain from ABA therapy make it worth trying, every time.
Does Insurance Cover the Cost of ABA Therapy?
Fortunately, ABA services are covered by the majority of health insurance plans, including Medicaid. Many states even mandate that health insurance companies cover ABA therapy. So as long as you have insurance, the “cost” of ABA therapy is determined by your specific healthcare plan.
The most important numbers to know are your Deductible and Out of Pocket Maximum.
Your Deductible is the amount you pay for covered healthcare services before your insurance plan starts to pay. Your Out of Pocket Maximum is the absolute most you will pay for healthcare services within a calendar year. Once you meet your Out of Pocket Maximum, insurance will cover the bill for any services you receive until your plan renews. For example, if your Out Of Pocket Maximum is $5,000, you’ll pay at most $5,000 per year for covered healthcare services, including ABA therapy.
Given the duration and recurring nature of ABA therapy, you should expect to hit your Out of Pocket Maximum when you enroll in ABA services. That is the “cost” of ABA. Having said that, many ABA therapy providers offer financial assistance or payment plans in order to minimize the cost for families.
Whenever your insurance changes, you should review your plan to see how your benefits have changed. Be sure to tell your ABA provider whenever your insurance renews or if you have recently changed employers or insurance plans.
One last note: Limiting the number of therapy hours your child receives isn’t an effective way to lower the cost of ABA therapy. Given the duration of ABA services (most children receive services for multiple years), you will hit your Out of Pocket Maximum whether your child receives 10 hours or 40 hours of therapy per week, so it’s worth it for your child to receive as many hours of therapy as recommended by a BCBA.
At Ascend Autism, we do our best to work with families so that cost is not a barrier to accessing services:
- We will check your coverage to make sure ABA therapy is covered by your insurance plan and determine exactly what the patient’s responsibility is so that there are no surprises.
- We only submit statements to families AFTER your insurance has processed the claim.
- We always offer families the option of a payment plan so that out of pocket costs that hit at the beginning of the year can be spread out into smaller payments over the course of the year.
- We offer financial assistance/hardship applications that may result in lower costs for families that qualify (based on annual household income.)
- We do accept Medicaid for each of the states that we operate, and Medicaid has no out of pocket costs.
We understand how difficult and frustrating it is to deal with health insurance – we do it every day. Give us a call today, and let us help you figure out what your coverage is and explain your options to you.
How Much Does ABA Therapy Cost Without Insurance?
Without utilizing health insurance, the cost for ABA therapy can vary widely across ABA providers, but it is likely that it will at least cost $75+ per hour. At that cost (regardless of the number of hours per week), it is prohibitively expensive for the vast majority of families to afford enough ABA therapy to be effective. This is why almost all families enrolled in ABA services are either partially or fully covered by their health insurance.
Does Ascend Autism Accept My Insurance?
Ascend accepts most major insurances. You can also contact us to confirm your benefits and discuss payment options.
