Does TRICARE cover ABA therapy for autism?
Quick Answer
Yes, TRICARE covers Applied Behavior Analysis (ABA) therapy for autism spectrum disorder, requiring a diagnosis from a qualified provider and authorization.
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Key Takeaways
- ABA therapy covered for autism
- Authorization required
- BCBA supervision required
- Regular progress reviews
Detailed Answer
TRICARE covers ABA therapy through the Comprehensive Autism Care Demonstration (ACD).
Eligibility
- Diagnosis of Autism Spectrum Disorder
- Age 0-18 (with some exceptions)
- Active TRICARE enrollment
- Authorization required
ABA Coverage
- Behavioral assessments
- Treatment planning
- Direct ABA therapy
- Parent/caregiver training
- Supervision requirements met
Authorization Process
- Diagnostic evaluation required
- ABA provider submits treatment plan
- Regional contractor reviews
- Regular reauthorization needed
Provider Requirements
- TRICARE-certified ABA providers
- Board Certified Behavior Analysts (BCBA)
- Registered Behavior Technicians (RBT)
- Must meet supervision ratios
Hours Allowed
- Based on medical necessity
- Regular progress reviews
- Intensity based on needs
- May decrease as progress is made
Related Questions
Does TRICARE cover autism services and therapy?
Yes, TRICARE covers autism services including Applied Behavior Analysis (ABA), speech therapy, and occupational therapy through the Autism Care Demonstration.
What is the ECHO program?
ECHO (Extended Care Health Option) provides additional services for military families with special needs dependents beyond standard TRICARE coverage.
How does TRICARE cover autism spectrum disorder?
TRICARE covers autism diagnosis, ABA therapy, speech therapy, occupational therapy, and medication through the Comprehensive Autism Care Demonstration.
What do most military families add to their TRICARE coverage?
Supplemental health insurance is the most common addition — it covers dental, vision, and out-of-pocket costs that TRICARE leaves uncovered. Life insurance and a legal will are also highly recommended.
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