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Will your insurance pay for an iPad for your child with autism spectrum disorder (ASD)

WORCESTER, MA…

Many parents of children with autism spectrum disorders have found applications like Proloquo2go App, TouchChat, OneVoice or TapToTalk to be very useful tools in their child’s speech development. Unfortunately, with the costs associated with programs for ASD children, many parents can’t afford to buy an iPad to run these helpful applications. There are, however, some insurance providers who will cover part or all of the expense of an iPad and applications.

“One of the challenges parents of children with ASDs face is not knowing what’s available for their children through their insurance provider and through their school system and that’s one of the things we help them with,” said Dr. Jeff Robinson, Ph.D., founder of Behavioral Concepts, Inc. (BCI), a company of behavioral clinicians specializing in the care of children with autism in Central Massachusetts. “It’s encouraging that healthcare providers are seeing the value of these apps and covering all or part of the expense.”

How do you find out if you are eligible? First, check your medical benefits for your “Durable Medical Coverage”. If your healthcare provider covers a percentage of these costs that makes it affordable to move forward, call your insurance company and ask to be assigned to a case manager who is experienced with special needs children.

In working with a case manager, you will need to essentially build a case for your child’s need for the iPad and, specifically, the Proloquo2goApp (this app is be is being introduced by speech therapists and occupational therapists in public schools for special needs kids as well as in private therapy). Provide links with costs for both the iPad and the application. Also send links to more expensive speech therapy systems like Dynavox to demonstrate how what you want to purchase compares to other systems. Be sure to ask the case manager for all the necessary approval codes and coverage information so you are aware and comfortable with any out-of-pocket expenses you may incur.

“During the phone conversation, you may be denied your request. If so, ask your insurance company to e-mail or fax a letter of denial. The reason for this is that there are other funding sources out there that might be able to help and you will need the denial letter from your insurance to help those efforts,” said Robinson.

If you have received the green light from your case manager, submit your Request for Approval with the following:

  • Include a cover letter explaining what you would like to purchase and why.  Explain how it will be used and what benefits it would provide your child.
  • Supporting documents from Google, etc.
  • Letters from doctors, speech therapists, etc. expressing “Medical Necessity”
  • Receipt of the device and the AugCom App

“Most likely, you will have to be reimbursed for your purchase of the iPad and application. Your reimbursement package should be fairly similar to the request for approval, only the cover letter will explain what you bought and for what reason, along with receipts,” said Robinson. “It may sound like quite a bit of effort, but it is absolutely worth give your child a learning tool like this.”

About Behavioral Concepts, Inc. (BCI)

Founded in 2002, BCI provides educational, behavioral, consultative and assessment services to children with autism and their families. These services are based on the principles of Applied Behavior Analysis (ABA) and are tailored to the unique needs of the individuals BCI works with. It’s BCI’s goal to maximize student potential, increase independence and enhance our clients’ quality of life within their home, school and community.

BCI’s main care center is located at 170 Goddard Memorial Drive, in Worcester, Massachusetts. BCI operates its BASICS services at 100 Hartwell Street in West Boylston, Mass. The BASICS program is a sub-contract arrangement between Behavioral Concepts, Inc. and the Central Massachusetts Special Education Collaborative. BASICS provides services to children aged 7-22 with autism and maladaptive behaviors. BCI’s Corporate Offices are located in Mansfield, Mass.

For complete information, visit http://bciaba.org or to arrange a consultation with a BCI clinician, please call (508) 363-0200.