Paying for Your ABA Therapy Program in Chicago: Insurance and Funding

Navigating insurance and funding sources can be challenging, especially when it comes to therapy for your child. Here at Illinois Autism Center, we know that securing the insurance to help manage the costs is important – we will guide you through this process and provide any support you need.

Steps to secure funding for your child’s autism therapy:

1. Obtain proper diagnosis.

This typically includes having a licensed psychologist, pediatrician, neurologist, or other professional provide an official diagnosis of autism spectrum disorder or related diagnoses in which ABA is a recommended treatment. This is usually an insurance requirement to qualify for ABA therapy coverage. Potential diagnosing services in the area include Hopemark Health, Advocate Health, and Ann & Robert H. Lurie Children’s Hospital of Chicago.

2. Find an in-network provider.

Currently, Illinois Autism Center is in network with Aetna and Blue Cross Blue Shield. We are in the process of contracting with Cigna. We do not take Medicare or Medicaid.

3. Understand your insurance policy.

Most insurance plans outline your deductible, copayment, or coinsurance, and out-of-pocket maximum – you can reach out to your insurance provider to get specific information about your plan. A deductible is the amount you pay for covered health care services before your insurance plan starts to pay. Typically, that means at the beginning of the year, you will be responsible for the entire cost of the sessions until you reach the deductible amount.

Copayment or coinsurance is the portion of the cost of the session you will pay after you meet your deductible. Coinsurance is typically a percentage of the cost, and copay is a fixed amount you pay per session or per day. You will continue to pay coinsurance or copay until you reach out of pocket maximum.

4. Be prepared to pay the bills.

The documentation from every session goes through several steps with the insurance company. They receive the request, review it, ask for additional information, and then determine the payment, including the portion paid by the client. The entire process could take up to several months, which could lead to a large bill for several months of service.

We will help you estimate and monitor your costs in advance so you can manage your payments and ensure uninterrupted ABA therapy services.