Co-Pays

Most insurance plans require a family to pay a co-pay every session to cover ABA services. Families should know what their co-pay is and if it is within their budget. If a co-pay is not within their budget due to financial constraints. Medicaid may be a good option to try to cover the costs of co-pays.  ABA providers are prohibited in their contract with insurance companies to cover these fee's.

 

Deductible

The deductible is the amount you must pay out of pocket to the Mental Health Agency for ABA Services before an Insurance Company will pay any expenses.

 

Cost Shares:

This means the share of costs covered by your insurance and the percentage amount you have to pay after your deductible is met. Generally, this means the family will have to pay 10%-30% on average for the cost of therapy until they meet their out of pocket maximum. 

 

Out of Pocket Maximum:

It is very important to find out what your out of pocket maximum is for ABA services. The lower the out of pocket maximum the less of the total amount you have to pay for services for the entire fiscal year or time period set by your insurance company. It is important to find out what time of the year your out of pocket maximum resets. We advise families to find out how much of the costs your insurance plan will cover before starting aba services.