Medicaid Coverage

Medicaid Coverage for Autism Therapy

Accessible healthcare is our top priority. Coverage varies by state, but Hopebridge accepts Medicaid for 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 partner with Medicaid in many states we serve. 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 many traditional state Medicaid plans and managed care partners. In addition to traditional state plans, here is a sample of our partners that cover autism therapy at Hopebridge:

  • Alliance Health
  • Amerigroup
  • Anthem
  • Arizona Complete Health
  • Banner University Family Care
  • Care 1st Health Plan
  • CareSource
  • 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. For the full list of participating payers by state, click here.

Medicaid FAQs

How much does ABA therapy cost?
If you have Medicaid or insurance, Hopebridge bill for services on your behalf whether as a Primary or Secondary payer. From there, your child’s specific clinical needs and plan will determine the out-of-pocket cost.

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.