Eligibility & Funding
Who is eligible for services?
Children from birth to 21 yrs of age who have a prior diagnosis or are in the process of receiving a diagnosis are eligible for our services. We work with children with dual or multiple diagnoses on behaviors, gross and fine motor skills, language development, physical challenges, and socialization. Although we provide services for individuals with developmental disabilities, we do not diagnose. A diagnosis must come from a doctor who specializes in developmental disabilities. We serve all socio-economic groups with respect and cultural sensitivity. We also provide parent education to help guide parents through the process.
How are services funded?
We accept Private Insurances such as Aetna, Cigna, Blue Cross Blue Shield PPO, United Health, CMS XIS (FL Medicaid), CMS XXI (Sunshine), Magellan (Avmed), Aetnrx, and Medicaid. In addition, we also accept temporary private pay. Private Pay may be accepted for specific goal interventions such as toilet training.
Insurance will cover therapy services for those diagnosed with Autism (ASD) or Down Syndrome (Trisomy 21). Other diagnoses may be covered on a private pay basis. We typically charge families at the same rate as Medicaid, as they are the most consistent and least expensive option. The Registered Behavior Technician (RBT) will work more closely and often with the child, implementing the goals from the behavior plan written by the BCBA. The BCBA will of course create the plan, conduct assessments, and provide supervision/oversight and parent training. For costs that insurance will not cover, other payment options may include MedWaiver or scholarships such as Gardiner (https://www.stepupforstudents.org/logins/special-needs-login/).
ABA is a much more intensive form of therapy that often requires a significant amount of hours to assist in changing behaviors. Children with less intensive needs may require fewer hours, about 10 hours a week, while more severe behaviors may require more than double: 25 to 30 hours a week. Insurance will have the final say on the hours approved for services after reviewing the plan written by the analyst. The number of hours that may be needed is good to consider when determining private pay costs as well.
