In this article, we will explore whether Cigna covers ABA therapy and what you need to know if you are considering this type of treatment.
The short answer is yes, Cigna does cover ABA therapy. However, the coverage may vary depending on your plan and the state you live in. In general, Cigna covers ABA therapy for children with ASD who are under the age of 21. The therapy must be medically necessary and provided by a licensed healthcare professional.
It is important to note that Cigna may require pre-authorization for ABA therapy. This means that you will need to get approval from Cigna before starting therapy. Your healthcare provider can help you with the pre-authorization process.
Cigna is a health insurance company that provides coverage for medical and behavioral health services. They offer a variety of plans, including employer-sponsored plans, individual and family plans, and Medicare plans. Cigna is one of the largest health insurance companies in the United States, with over 180 million customers worldwide.
Cigna covers ABA therapy as a behavioral health service. This means that it is subject to the same deductibles, copays, and coinsurance as other behavioral health services. Your specific coverage will depend on your plan and the state you live in.
In general, Cigna covers up to 40 hours of ABA therapy per week for children with ASD who are under the age of 7. For children between the ages of 7 and 21, Cigna covers up to 25 hours of therapy per week. The therapy must be provided by a licensed healthcare professional who is trained in ABA therapy.
If you or a loved one has ASD and you are interested in ABA therapy, the first step is to talk to your healthcare provider. They can help you determine if ABA therapy is appropriate and if it is covered by your insurance plan.
If you have Cigna insurance, you should also contact your insurance company to find out what your specific coverage is for ABA therapy. They can provide you with information on deductibles, copays, and coinsurance, as well as any pre-authorization requirements.
While Cigna covers ABA therapy, there may be instances where your request for coverage is denied. If this happens, you have the right to file an appeal with Cigna. Here are the steps you can take to file an appeal:
It's important to note that the appeals process can be complex and time-consuming. Consider seeking assistance from an experienced healthcare advocate or attorney if needed to ensure that you have the best chance of success in obtaining coverage for ABA therapy through Cigna insurance.
If you have Cigna insurance and are planning to receive ABA therapy, there are a few things you can do to maximize your coverage and minimize your out-of-pocket costs. Here are some tips to keep in mind:
By following these tips, you can help ensure that you are getting the most out of your Cigna insurance coverage for ABA therapy while minimizing your out-of-pocket costs.
ABA therapy is a valuable treatment option for children and adults with ASD. If you have Cigna insurance, you may be able to get coverage for this therapy. However, it is important to understand your specific coverage and any pre-authorization requirements before starting therapy. Talk to your healthcare provider and your insurance company to get the information you need to make an informed decision about ABA therapy.