Please help! Insurance Question Texas.
Hello everybody. I am trying to get my son ABA therapy after a year of school and when I previously had him in ABA it was through Obama care which was $1000 max out-of-pocket which I reached and it was simple enough but now he has CHIP, which isn’t covered for ABA in Texas. My enrollment window at work is open and I can’t figure out if it’s worth using my own insurance for ABA therapy. I called Blue Cross Blue Shield of Texas and also the ABA center he went to and none of them can give me a straight answer on what my cost would be. There is a section called habilitative services and there’s another section that states if you need behavioral health this is what your coinsurance will be. Deductible does not apply when it comes to autism. On one side it says if you need Behavioral health, the coinsurance is 40% for outpatient services on the other hand under habilitative services. It says $40 co-pay PCP or $70 co-pay specialist and then underneath that it says 40% co-pay. I’m trying to figure out if ABA will be billed under rehabilitative services or the regular behavioral health because when I google anything it says ABA can be billed habilitative if I do $70 or $40 a day for three days a week it’s under $500 or something when I call Blue Cross Blue Shield. The lady couldn’t even figure out what I was saying. Can someone please help me understand what I should estimate my cost will be?
(Sorry for formatting also jumbled sentences I just want my baby in therapy 😭)