Illinois

Is ABA Therapy for Autism Covered by Medicaid in Illinois?

Yes, ABA therapy in Illinois is covered by Medicaid and overseen by the Illinois Department of Healthcare and Family Services (IDHFS).

What is ABA Therapy?

ABA stands for applied behavior analysis. Doctors, psychologists, and behavior specialists agree that ABA is the gold standard in treatment for autism.

All U.S. states have laws that require insurance companies to cover autism screenings, diagnosis, and treatment. This includes coverage for ABA therapy.

Contemporary ABA therapy — the approach we take at Total Spectrum — is backed by decades of research. ABA therapy can be provided in our Learning Centers, at home, in the community, or at school.

At Total Spectrum, we personalize your child’s ABA treatment to help them:

• Build language and communication skills
• Develop social and play skills, while forming friendships
• Increase flexibility and tolerance for new routines and experiences
• Decrease behaviors that interfere with growth and learning
• Prepare for and succeed in school

How Can My Illinois Child Receive ABA Therapy Via Medicaid?

If you have Medicaid in Illinois, you can breathe a sigh of relief. Children and young adults under the age of 21 who are enrolled in Medicaid can now access ABA therapy services.

Historically, families experienced difficulties accessing ABA services through Medicaid in Illinois. However, with recent changes, families now have greater access to ABA services with companies like Total Spectrum. In Illinois, applied behavior analysis (ABA) services are called Adaptive Behavior Services (ABS), and the clinicians and BCBAs who oversee ABS services are referred to as ABS clinicians.

It’s important to keep in mind, though, that not all ABA providers accept Medicaid. It’s key to find an ABA service provider that accepts Medicaid to make sure your child’s therapy will be covered.

At Total Spectrum, we accept Medicaid and have you covered when it comes to providing ABA treatment.

What Is the Process for Getting Connected With an ABA Provider?

To access ABA therapy through Medicaid in Illinois, you need to follow these steps (If your child already has an autism diagnosis then skip to step 3.):

1. Receive a Diagnosis of Autism
If you’re concerned that your child may have autism and has not yet been diagnosed, reach out to your pediatrician to discuss your concerns and get a referral for a Comprehensive Diagnostic Evaluation (CDE) by a physician or licensed psychologist.

2. Select an ABA Provider
Once your CDE is complete, you can choose an ABA therapy provider from the approved list provided by your Medicaid plan. Consider factors such as location, availability, and expertise when making your choice. You can find out where Total Spectrum provides services here.

To find a list of providers, reach out to your specific Medicaid plan (Managed Care Organization):

• Aetna Better Health
• Blue Cross Community Health Plans
• YouthCare
• Meridian Health
• Molina Healthcare
• CountyCare Health Plan       
  

3. Get an Assessment from a Behavior Analyst
Work with your chosen ABA therapy provider to get an initial assessment for ABA services from a board certified behavior analyst (BCBA). The initial assessment will include an evaluation of skills (such as communication and play skills), identification of behavior challenges, and provide recommended goals and hours for therapy.

4. Begin ABA Therapy
Once you have received your initial ABA assessment and treatment plan, you can start ABA therapy for your child.

Additional Resources

In addition to ABA therapy coverage, Illinois Medicaid offers other supports for kids with autism. These include speech therapy, occupational therapy, physical therapy, and more. Be sure to explore these resources to provide comprehensive care for your child or young adult.

Avoiding Roadblocks

By following the steps outlined above, you can navigate the process and avoid roadblocks.

Remember, you’re not alone in this process. Total Spectrum has dedicated professionals who can help you every step of the way. Reach out to us by clicking below.