Benefits of Medi-cal's behavioral therapy coverage plans
- If the family’s primary insurance plan does not cover ABA, beneficiaries will need a refusal letter from their insurance carrier to use the Medi-cal plan.
- At Medi-cal, the state and federal governments split the cost of the insurance cover.
- BHT services will be provided to children with fee-for-service Medi-cal through their local regional center.
- A professional physician or psychologist provides the diagnosis
- A Board Certified Behavior Analyst (BCBA) develops the individualized treatment plan.
- The insurance provider will engage with members and communicate directly with their physicians through their comprehensive case management framework to coordinate therapy and services for high-risk members.
- The Medi-cal recipients have their care navigator, a customer support specialist, a free 24-hour nurse support line, health programs, a caseworker, and other services are available.
You will need to produce a written diagnosis from a medical doctor, psychologist, or psychiatrist that contains a referral for ABA therapy to be authorized by Medi-cal.
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References
- https://www.dhcs.ca.gov/services/medi-cal/Pages/default.aspx
- https://www.blueshieldca.com/bsca/bsc/wcm/connect/sites/sites_content_en/bsp/cmc-members/cmc-members
- https://www.dhcs.ca.gov/services/medi-cal/Pages/BehavioralHealthTreatment.aspx\
- https://www.autismlearningpartners.com/medi-cal-autism#
- https://www.coveredca.com/medi-cal/