Understanding and accessing TRICARE coverage for Applied Behavior Analysis (ABA) services can be a complex process, but we are here to help simplify it for you. This blog aims to simplify the process of understanding and accessing TRICARE coverage for ABA services.
At Better Together Behavioral Health, our mission is to meet the distinct needs of the local autism community, specifically focusing on the marginalized Latin and transient military communities. We strive to create a team that is reflective of and immersed in the diverse community we serve. We understand that military families often face unique challenges, including finding the best care for their children with autism. As an ABA therapy service provider, we are committed to helping you navigate the system to ensure your child receives the highest quality care.
What is TRICARE?
TRICARE is the regional health care program serving uniformed service members, retirees, and their families in the United States. For families with children diagnosed with Autism Spectrum Disorder (ASD), TRICARE offers coverage for ABA services, an evidence-based treatment that helps improve social, communication, and learning skills.
Understanding TRICARE ABA Coverage
TRICARE covers ABA therapy under the Autism Care Demonstration (ACD) program. This program is designed to provide specialized services to children with autism, ensuring they receive the support they need to thrive.
https://www.tricare-west.com/content/hnfs/home/tw.html
Eligibility Requirements:
- Diagnosis: Your child must have a diagnosis of Autism Spectrum Disorder (ASD) from a TRICARE-authorized provider.
- Referral and Authorization: You will need a referral from your primary care manager (PCM) and authorization from TRICARE to begin ABA services.
- Comprehensive Care Plan: An individualized treatment plan must be developed by a TRICARE-authorized ABA provider.
Steps to Access ABA Therapy through TRICARE West
- Obtain a Diagnosis: Ensure your child is diagnosed with ASD by a TRICARE-authorized provider.
- Get a Referral: Contact your PCM to obtain a referral for ABA therapy. Your PCM will submit the referral to TRICARE for authorization.
- Choose a Provider: Select a TRICARE-authorized ABA provider. At Better Together Behavioral Health, we are proud to be a TRICARE-authorized provider for Fort Bliss, in El Paso TX.
- Develop a Care Plan: Work with your chosen provider to develop a comprehensive, individualized treatment plan for your child.
- Complete Assessments: Be prepared to complete assessments required by TRICARE to track your child’s progress and ensure the effectiveness of the ABA therapy.
- Start Services: Once TRICARE approves the authorization, you can begin ABA therapy services.
Parent Involvement and Guidance
Active participation from parents is crucial for the success of ABA therapy. At Better Together Behavioral Health, we emphasize the importance of:
- Caregiver Guidance: Regular guidance equips you with the skills needed to support your child’s progress at home.
- Home Practice: Implementing ABA strategies in daily routines to reinforce learning and behavior changes.
- Assessments: Be prepared to complete periodic assessments required by TRICARE West, such as the Parental Stress Index (PSI) and the Vineland Adaptive Behavior Scales. These assessments provide valuable insights into your child’s development and help adjust the care plan as needed.
Tips for a Smooth Process
- Stay Informed: Regularly check TRICARE official website or contact their customer service for updates and information on ABA therapy coverage.
- Keep Records: Maintain thorough records of your child’s diagnosis, referrals, authorizations, care plans, and completed assessments.
