Medical Treatment: Insurance or Government Pays

Treating autism spectrum disorders as a medical difficulty is where most people begin. Medical treatment includes anything requiring a doctor's prescription or supervision, including drugs, psychologists, behavioral therapy, group social skills therapy, occupational therapy, physical therapy, and speech therapy.

Notice that there's a definite overlap between medical treatment and the treatments for developmental or educational reasons. Medical therapy, since it's done for medical reasons, also has very different funding and listed prices. Medicaid, ARKids, TEFRA, Tricare, HCBW (Home and Community Based Waivers), and Private Insurance are all ways to pay for medical treatment.

Medical treatment also faces very different levels of costs, benefits, co-pays, and paperwork hassles. The government insurance programs such as medicaid, ARKids, TEFRA and HCBW all have difficult application processes and eligibility requirements. While the local DHS office may be able to help with some of your questions, a better resource is the DHS office of Children's Medical Services, 501-682-2277. These applications are very difficult to complete, so discussion with a friendly staffperson is essential. The Arkansas DHS website lists additional services for the developmentally disabled.

A more disabled child can also enter the DDTCS preschools, which provide more intensive services for children. Individuals with autism who are no longer in school may also access the DDTCS services.

Arkansas medical treatment insurers, with the exception of millitary Tricare, will NOT cover direct autism treatment. No ABA treatment, no direct psychiatric treatments for therapies for autism. The minute any doctor or therapist puts down that the treatment is for autism, there will be no payment from any type of insurance.

Medical treatment can, however, be sought for all of the conditions around autism: anxiety, OCD, ADHD, fine motor skill delays, physical delays, and speech delays. So parents should not completely abandon insurers, but it is very frustrating to navigate the reimbursement rules.