Some With Autism Still Denied ABA

autismby Kate Harrington, Kaiser Health News | July 13, 2016

Like many parents of children with autism, Braulio De La Cruz sought an expensive therapy called applied behavior analysis — or ABA — when his son Noah Leonardo was diagnosed last year.

Noah, now 3 years old, qualifies for Medicaid coverage because he had been approved for Social Security’s Supplemental Security Income (SSI) program, and his neurologist sent paperwork to get the state to cover the therapy. But Medicaid officials rejected the request. Braulio De La Cruz appealed the decision, but that effort hit a major roadblock last fall when the state suddenly said the Medicaid program would not cover behavior therapy.

Now De La Cruz, of Houston, and other parents — who say their children with autism are legally entitled to such treatment — are butting heads with Texas officials. And without Medicaid coverage, they must either forgo the therapy or find a way to pay for individual insurance plans that help pick up the costs.

De La Cruz has turned to an individual Humana plan to cover his son’s therapy. But it costs him $198 a month, a small fortune when he is watching expenses closely while preparing to go back to school to study nursing. And the cost goes beyond just the premium.

“The most difficult part is the deductible,” he said. “It’s $6,500 — it’s pretty outrageous that you have to pay that before anything is covered.”

The article continues here: https://www.readability.com/articles/bi3qwc1o