From Coverage Provided by Medicaid, Children’s Health Insurance Program (CHIP), the Veterans Administration, Federal Employees Health Benefit Program, Affordable Care Act Coverage and Commercial Health Insurance Programs
The Department of Defense has asserted that Applied Behavior analysis (ABA), referred to as the “gold standard” therapy for children with autism, does not meet their hierarchy of evidence to be a standard benefit under the TRICARE health benefit program for military families. Every other health benefit/insurance program listed above asserts it meets their standards.
TRICARE does not cover ABA services provided by a behavior technician in schools and community settings. Every other health benefit/insurance program listed above does.
TRICARE requires new entrants into the Autism Care Demonstration to wait up to 90 days for an “Autism Services Navigator” to prepare a Comprehensive Care Plan before being able to access ABA services. None of the other health benefit/insurance programs listed above requires such a wait.