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Medicaid Coverage

Medicaid Coverage for Autism Therapy

We have you covered. Hopebridge accepts Medicaid for all of our autism treatment services, from autism testing to full-time ABA therapy.

Check Your Eligibility

Hopebridge is a Medicaid Provider

From the beginning, our vision has always been to provide accessible, high-quality care to children and families touched by autism. As part of this goal, we participate in Medicaid in every state we serve. Diagnostic evaluations for autism, applied behavior analysis and other complementary therapies at Hopebridge will come at no extra cost if your child’s Medicaid plan covers them. As your eligibility for Medicaid or life circumstances change, our Care and Benefits Coordinators are there to guide you through the process.

Medicaid Partners

Hopebridge works with all traditional state Medicaid plans and virtually every managed care partner, plus we are constantly expanding our relationships as we grow. In addition to traditional state plans, here is a sample of our partners that cover autism therapy at Hopebridge:

  • Amerigroup
  • Anthem
  • Arizona Complete Health
  • Banner University Family Care
  • Care 1st Health Plan
  • CareSource
  • Health First Colorado
  • Medicaid Mutual
  • MDWise
  • MercyCare
  • MHS
  • Passport Health Plan
  • Peach State Health Plan
  • UHC UnitedHealthcare Community Plan
  • WellCare Health Plan

Don’t see your Medicaid provider listed? Don’t sweat. This is just a short list of our partners, and even if we do not already accept your plan, our Care and Benefits Coordinators can work on single case agreements to arrange a contract with your coverage provider.

Medicaid FAQs

How much does ABA therapy cost?
If you have Medicaid or insurance, Hopebridge bills them on your behalf. From there, your child’s specific clinical needs and plan will determine the out-of-pocket cost, though Medicaid typically covers the entire cost for autism-related services.

What do I have to pay out of pocket for services?
There is typically no financial out-of-pocket cost for children on Medicaid whose plan covers ABA therapy and our other services.

How many hours will we be approved for?
Coverage is based on medical necessity and ranges from 10 to 40 hours. Our team will submit your plan of care to the Medicaid provider and they will review and let us know what is covered.

How do I apply for the Medicaid waiver?
Certain states offer Medicaid waivers based on income and clinical criteria. Caregivers should submit their child’s diagnostic paperwork to the state’s Medicaid or disability coverage in order to apply for additional coverage. We recommend visiting your state’s Medicaid website to find out more information.

Extra Tips for Utilizing Medicaid Coverage

At Hopebridge, our parents are pretty savvy! While you likely know the ins and outs of Medicaid, here are a few extra reminders for using your coverage:

When it comes to matters of healthcare coverage, it is important to be responsive. We recommend staying engaged with healthcare-related correspondence, whether it comes from Hopebridge, Medicaid or your insurer.

If circumstances should change and your eligibility for Medicaid changes with it, caregivers remain responsible for the cost. When it comes time to renew Medicaid, we also recommend caregivers do it immediately upon receiving it in the mail. Staying engaged and renewing quickly ensures your child will not have breaks in coverage.

Be mindful of attendance in therapy. Not only is participation important to your child’s progress and development, but state Medicaid plans review their presence according to their plans of care. If the percentages of attendance appear low, it will affect the number of hours children will be authorized to receive therapy.

We Have You Covered: Let Us Advocate for You

Our Care and Benefits Coordinators are here to help you get the benefits available through your plan. This experienced and dedicated team ensures care is facilitated with minimal headaches when dealing with insurance coverage for ABA therapy and autism service. From determining eligibility and out-of-pocket expenses, to obtaining authorizations and clinical rationale to appeal denied claims, they take on the legwork to lessen your burden and make sure your children get the care they need.

Learn more about your family’s options by calling our Care and Benefits Team at (855) 324-0885.