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Does United Healthcare Cover ABA Therapy in Nebraska?

Applied behavior analysis is often prescribed for children with autism spectrum disorder (ASD). ABA therapy, as it’s also known, is a science-based approach to learning that helps children with autism build communication and social skills while modifying certain behaviors.

For many children on the autism spectrum, ABA therapy is intensive — often requiring multiple hours per day and multiple days per week. This means that it’s not only time-consuming for children and their families but can also be costly.

That’s why many parents of children with autism wonder whether they can get ABA therapy covered under their insurance plan.

In this article, we’ll discuss whether United Healthcare covers ABA therapy in Nebraska.

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

Table Of Contents

What Insurance Plans Does United Healthcare Offer?

United Healthcare is one of the largest insurance carriers in the country. Their programs provide insurance coverage to millions of people throughout the U.S.

They offer a wide variety of plans, such as individual plans, employer-sponsored plans and even Medicare Advantage plans. Through all of these plans, United Healthcare has a large network of different healthcare facilities and providers, which offers great access to the members who subscribe to their plans.

Does United Healthcare Cover ABA Therapy in Nebraska?

Generally speaking, United Healthcare offers coverage for ABA therapy in Nebraska. Many of their plans are subject to the state’s autism insurance bill, which went into effect at the beginning of 2015.

According to state law, all insurance plans that must adhere to it have to provide coverage for a variety of autism-related health services. This includes diagnoses, pharmacy care, psychiatric care, psychological care, therapeutic care such as speech or occupational therapy, and behavioral health care such as ABA therapy.

Since United Healthcare offers so many different types of insurance plans, though, there’s no one across-the-board rule or answer to whether they cover ABA therapy or what type of coverage they provide.

It’s important that you dive deeper into your specific insurance plan with United Healthcare to figure out what you are covered for.

Feature Details
Covered Service ABA Therapy for children with ASD
Age Limit Up to 21 years old
Weekly Hour Limit 25 hours (minimum per state law)
Diagnosis Requirement Must be diagnosed by a qualified professional (e.g., developmental pediatrician, psychologist)
Medical Necessity Required documentation and professional recommendation
Pre-Approval Needed Yes, including treatment plan submission
In-Network Provider Requirement Typically required
Parent/Caregiver Training Covered Often included
State Law Mandate Yes, since 2015

Are There Limits to ABA Therapy Coverage in Nebraska?

According to state law, autism insurance coverage is limited to individuals who are 21 years old or younger. ABA therapy services have a limit of 25 hours per week.

Insurance companies that must adhere to Nebraska’s state law only have to provide this minimum coverage. They can, of course, decide to offer more coverage than this if they choose, such as allowing more than 25 hours per week of ABA therapy.

What Else is Required to Have ABA Therapy Covered by United Healthcare?

United Healthcare’s different insurance plans may have slightly different requirements when it comes to having your child’s ABA therapy covered. There are some general rules of thumb that you should be aware of, though.

First, your child will need to be officially diagnosed with ASD, and this must be done by a professional who is qualified to give such a diagnosis. In most cases, this can be a developmental pediatrician, clinical psychologist or some other specialist.

Next, the professional who gave the diagnosis must then recommend your child for ABA therapy, based on the fact that it’s medically necessary for them. You likely will have to provide documentation to United Healthcare of the diagnosis and the recommendation.

After ABA therapy has been approved for your child, you may need to receive pre-approval for the facility or provider you choose. Your insurance plan likely will have a list of in-network providers you can visit.

Finally, once you’ve chosen a provider from the list, they will likely need to submit an official treatment plan so that your child’s ABA therapy sessions are approved.

In many cases, United Healthcare will cover your child’s ABA therapy sessions and other related services, including training for parents, caregivers and other family members so your child can be better supported at home.

Criteria Requirement Notes
Diagnosis by Qualified Professional ✅ Required Must be formal and well-documented
Provider Pre-Approval ✅ Often Needed Choose from UHC’s in-network list
Treatment Plan Submission ✅ Required For ongoing session approval
Max Weekly Hours 25 hrs/week Per Nebraska mandate (plans can offer more)
Coverage Age Cap ≤ 21 years Applies under state law
Parent/Caregiver Support ✅ Frequently Covered As part of therapy framework

Blue Gems ABA Work with United Healthcare in Nebraska

United Healthcare is one of the largest insurance carriers in the country, and offers coverage for ABA therapy in Nebraska under many plans. If your child has been diagnosed with ASD, make sure to check your specific plan to see what coverage you have.

At Blue Gems ABA, we work directly with insurance carriers such as United Healthcare in Nebraska so we can help support children with autism and their families better.

We have a team of experienced professionals who can diagnose ASD and also administer ABA therapy on a one-to-one basis, helping children build the skills necessary to live a more independent life.

To learn more, please contact us today.