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TRICARE Comprehensive Autism Care Demonstration

The TRICARE Comprehensive Autism Care Demonstration (Autism Care Demo) combines the existing Applied Behavior Analysis benefitsThe existing ABA benefits include a combination of the basic TRICARE benefit with the ECHO Autism Demonstration or the ABA Pilot Program.
into a single program for everyone with Autism Spectrum Disorder.
The demonstration starts on July 25, 2014. It will end on December 31, 2018.

  • If you’re getting ABA now, you won’t lose coverage
  • We will transition your current ABA benefits to the new program before December 31, 2014
  • We are finalizing how the Autism Care Demo will work
  • We will update this page with details

What’s new about the Autism Care Demo?

What do I need to do now?

If you’re already getting ABA through TRICARE:

  • We’ll phase you seamlessly into the Autism Care Demo
  • You don’t need more testing, referrals, or authorization
  • Keep getting care under your current treatment plan
  • Your provider will get a new referral and authorization when required

If you’re diagnosed with Autism Spectrum Disorder after July 25, 2014:

  • You’ll get the current benefits and transition to the Autism Care Demo by December 31, 2014
  • Contact your regional or plan contractor to see what you need to do get started

How much will I pay for ABA under the Autism Care Demo?

Your plan and type of provider determine how much you’ll pay for ABA.

If you see a Board Certified Behavior Analyst with a master’s degree or higher:

If you see a Board Certified Assistant Behavior Analyst or a Behavior Technician (formerly called an “ABA Tutor”):

  • You’ll pay a 10% cost share* for supervised ABA
  • This amount doesn’t count toward your annual catastrophic cap

*Active duty family members must register for the Extended Care Health Option (ECHO) to participate in the Autism Care Demo. The monthly ECHO fees will satisfy the 10% cost share for supervised ABA.

Save Your Receipts!

You should save your receipts for ABA services until you’re fully transitioned into the Autism Care Demo.

Last Updated 9/25/2014

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