My son diagnosed with mild ASD at 18 months. He is 3yrs old now and we are doing ABA from 20months. He has improved a lot with ABA and now we are planning to move to Texas,USA. Could anyone please help us providing details of therapy rates , insurance coverage for therapy and inclusion in playschool in US?
Are you moving from one State to other in US, or moving from India ? Where was he diagnosed?
To start ABA, you need to have diagnosed report from US. Normally wait time is more here( it may take 4 to 5 months).
The option is to get a private doctor evaluation for insurance company to get it diagnosed. It will do, that evaluation can also help you get your IEP(Individualized Education Plan) where he/she can get extra help in school in public school for OT,PT and Language therapy.
Texas known to be having better services for special needs child.
The Doctors who take insurance for ASD evaluation generally have lot of wait time. Best it to get the Evaluation done from the doctor readily available even if that means paying from pocket for that, because that will set you for you insurance to provide you ABA which is very expensive otherwise and insurance need evaluation to provide the service.
Hope that helps.
Good luck with you move.
Kids from age 3 is eligible for special education services through school as part of IEP. You need to contact school for evaluation. It will also take time, you may have three appointments with them, finally they will come up with IEP for ur kid. Your pediatrician can guide you to get properly diagnosed, which u need for ABA. For speech and OT, it is NOT mandatory to have d report, still they need some documents which prediatrician can provide.
Regarding insurance, most of the insurances cover medical benefits as well as behavioral benefits. Coverages would be like 80 - 20, 90 - 10. To make it short, you may have to pay max till you reach your out of packet. Deductible and out of packet varies, depends on plan. With insurance coverage, per year, it could be from 1000$ to 5000$. Please note, it all depends on each individual insurance plan.
We were in Texas until March 2016 and then returned back to India after which he is diagnosed. We tried therapies in India but didn't go well and finally moved to Dubai on visit visa and have been doing therapy for a year. He has improved a lot after giving intense ABA ( 10 hours a week ). We can continue in Dubai only till March. Tried for admission at play school and regular school in India but didnt succeed. We have option to move back to Texas but vary of the expenses for therapy.
Im curious to know more when you said wait time is 4-5 months. Is it for school , to get a therapist or for diagnosis?
Do insurance provider accept evaluation if it's not done by a doctor in their network?
Yes your reply is very informative.Thanks
Thank you for the valuable information
School is evaluation process may take from 1 to 4 months. It may vary upon states. I don€™t reside on Texas, so I am not sure about it. Once evaluation s over, they would provide IEP for ur kid, could be in school services includes ST, OT
For ABA, in general the process takes time. ABA provider would be working with your insurance to get authorization for assessment. There would be 4 to 5 months wait time.
@ anooha yes they will accept the evaluation as long as it is from a US doctor with the state. I may be wrong for other insurances but athena and united does accept it and frankly the co-pay for those session (again based on plan) but are very minimum like $30 per session and session can be 1 hr to 8 hr copay stays the same.From public school perspective as soon as you enroll the kid in to school you can provide that evaluation but they will wait for their IEP meetings which happens twice yearly around sep and Jan where the discuss the progreess of kids with parent and teacher and IEP coordinator. but again u need to get him evaluated but public school evaluation team which generally takes 4-5 months all process included.
Also do not forget to apply Mackay scholarship once you have completed 1 year in public school system and student has IEP last date for application is generally jun end once you have IEP from previous year.
One you get Mackay approved you can enroll your kid in private school of your choice as well and state will pay the approved scholarship amount which can vary but generally it is sufficient to cover school fees.
@ anooha as you kid is still prek.. you can avail early steps services at home therapy as well till he is 5 years sooner you apply sooner you get them they provide inhome therapies till 5 years age but it takes some time as well after evaluation from early steps coordinator this is also government funded program.
I think Mackay scholarship and early steps services are available only in FLORIDA. The state where I live has Infant toddler program ( till child turns 3 ) and IEP in school ( after 3). Thank you @rohittampa, good to know abt these services in other states
We had a look at the company provided health insurance plan. It supports PT,OT & ST for autism up to 60 visits, all inclusive.
It doesn't say about ABA and i believe 60 visits will not be enough for my son. Right now he is given 10 hours of ABA per week. I think we will have to buy additional insurance to meet ABA needs.
I was searching for insurance plans and providers but it seems like it's very expensive to buy insurance from outside.
Anybody has experience buying health insurance in addition to the employer provided one in Texas?
We cannot move to US unless we are sure about the expenses required to meet therapy needs.
Other than having a huge wait time in private ABA therapy practices, you don't need to worry much if you are in US.
The school district provides special classes, which will be in addition to any ABA therapy at home.
Insurance would cover most of the costs (depending on your plan. Either you pay low premium but have high deductible, or high premium low deductible.)
School IEP co-odinator will asses your child.
And the child needs to be assessed by Individual Psychiatrist (only after which insurance will provide).
Hi rohit, could you please accept my friend request? I too live in your state. Need to ask feq questions. Please respond. Thanks
Where did you move in Texas. We are also planning to move Austin
We are currently living in San Antonio
@anooha do you know anyone in Austin doing ABA ?
Hi Parents, I am new to this website and I have read the whole discussion. My son is 2.5 years old and has been receiving ST and OT from past 3 months. We are on a huge waiting list of 8 months for ABA Therapy in Indiana state :(
We are planning to move to Houston,TX very soon. Can anyone please recommend good ABA therapy centers along with OT and ST in Houston, TX.
Can you please contact via email?
My id: firstname.lastname@example.org