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.