Does Cigna Cover ABA Therapy in Nebraska?

Acceptance, understanding and support for people with autism spectrum disorder (ASD) has come a long way in recent years. A majority of states, in fact, have passed legislation over the last 20 years that mandates certain levels of insurance coverage for autism-related care.

Nebraska is one of those states that mandates this type of coverage for some insurance plans. For many families, this means that their child’s ASD diagnosis and treatment plans must be covered by insurance, depending on the type of plan that they have.

This is great news for parents of children with autism in Nebraska, as treatment such as applied behavior analysis, or ABA therapy, can get costly due to the fact that children often require 20 or more hours per week of it.

In this article, we’ll discuss whether Cigna covers ABA therapy in Nebraska, and what the limitations and requirements are.

Learn more about insurance coverage for ABA Therapy
Learn more about Insurance coverage for ABA Therapy in Nebraska

Table Of Contents

What is Cigna?

Cigna is a rather large health insurance company that provides coverage for individuals and families all across the United States. They offer many different plans, including employer-sponsored plans, individual plans through state marketplaces and even some Medicare plans.

The details of what Cigna will cover depends greatly on the specific insurance plan that you have. This makes it very important for you to be familiar with your specific plan, as your coverage may vary greatly from other plans — even if they’re all offered by Cigna.

What Autism-Related Coverage Does Nebraska Mandate?

As of 2015, Nebraska’s autism insurance bill went into effect, which mandated that certain insurance plans had to comply. Only individual non-grandfathered plans and fully insured small group non-grandfathered plans are exempt from the law.

Nebraska’s law states that many different autism-related services must be covered by insurance companies, including diagnosis; psychological, psychiatric and pharmacy care; therapeutic care, including physical, occupational and speech therapy; and behavioral health services, such as ABA therapy.

The state law does say that individuals must be 21 years of age or younger to be eligible, and insurance plans only have to cover up to 25 hours of ABA therapy per week.

What Does Cigna Require for ABA Therapy to Be Approved in Nebraska?

Many of Cigna’s insurance plans in Nebraska must adhere to the state’s autism insurance law. Again, though, some may not, so make sure to check your specific plan.

In addition, the state law only lays out the minimums for what coverage must be given. Some of Cigna’s plans, then, may actually offer greater coverage than that.

Regardless of what coverage your insurance plan provides for ABA coverage, Cigna will generally require the following things to approve autism-related services …

• Diagnosis: Your child will need to receive an ASD diagnosis from a qualified professional, such as a clinical psychologist, developmental pediatrician or other specialist.
• Referral: The person giving the ASD diagnosis must then refer your child for ABA therapy. This referral will typically need to point out that the treatment is medically necessary.
• Provider: Cigna may require you to visit a certain ABA therapy provider for it to be covered. They typically will have a list of providers who are in your network.
• Pre-Approval: Your child’s ABA therapy treatment plan may need to be approved by Cigna before it can begin. The insurance carrier may also require progress updates every six months or so for the continuing treatment to be covered.

Should your child be diagnosed with ASD and ABA therapy is recommended for them, it’s important that you immediately reach out to Cigna to figure out what coverage is offered to you, and what you must do in order to get that coverage approved.

If you don’t follow the steps that Cigna requires, you may find that your child’s ABA therapy isn’t approved.

Blue Gems ABA Works with Cigna Insurance Plans in Nebraska

Cigna provides coverage for ABA therapy in Nebraska under many of their plans. Whether your child can receive coverage for their ABA therapy, and what coverage they might receive, depends on your specific plan, though.

At Blue Gems ABA, we work with Cigna and many other health insurance plans in Nebraska so we can better support children with autism and their families. We have trained professionals who can accurately diagnose your child with ASD, as well as a team that is experienced in administering successful ABA therapy treatment plans.

To learn more, please contact us today.