At Beyond The Spectrum ABA Therapy (BTS), we understand that navigating insurance and payment options can feel overwhelming. Our team works with families to help clarify coverage options and provide information about available resources.
Below is an overview of the insurance and payment options families commonly use when seeking services.
Commercial Insurance
BTS works with a variety of commercial insurance plans. Coverage, authorizations, and approved service hours are determined by each insurance provider and are based on medical necessity and plan benefits.
Because coverage varies by plan, families are encouraged to contact their insurance provider directly to understand their specific benefits, deductibles, and authorization requirements.
Medicaid
Medicaid is a public insurance program that may cover medically necessary services for eligible children. Eligibility and coverage are determined by the State of Georgia and may depend on income, disability status, and other factors.
Some families use Medicaid as:
- Primary insurance, or
- Secondary insurance alongside a commercial plan
Medicaid coverage does not guarantee specific service hours and is subject to authorization and medical necessity requirements.
Katie Beckett (Deeming Waiver)
Katie Beckett, also known as the Deeming Waiver, is a Georgia Medicaid eligibility program for children under age 18 with significant disabilities. Unlike traditional Medicaid, eligibility is based on the child’s income and resources, not the parents’ income.
Some families explore Katie Beckett when private insurance coverage is limited or when a child has significant support needs. Approval is not guaranteed, and the application process is managed by the State of Georgia.
Learn more about Katie Beckett and how to apply:
Katie Beckett (Deeming Waiver)Private Pay
Some families choose private pay options for services that are not covered by insurance or while waiting for insurance determinations. Private pay arrangements are discussed directly with families based on availability and service needs.
Important Notes About Coverage
- Insurance approval and service hours are determined by payers, not by BTS
- Coverage does not guarantee a specific number of therapy hours
- All services must meet medical necessity and authorization requirements
- BTS does not guarantee insurance outcomes or approval decisions
