Healthcare Insurance Marketplace Tips for Parents of Children with Autism

November 1 marks the beginning of open enrollment on the Healthcare Insurance Marketplace.

Whether you’re new to the Marketplace or an old pro, please take action before time gets away from you during the holidays to ensure your child’s ABA therapy needs are covered by insurance for next year. We know it can be a hassle, but you’ll be glad you did!

Here are important things to keep in mind:

Don’t assume you’ll be re-enrolled automatically.
If you’re happy with your current Marketplace insurance plan and nothing has changed about your personal information or situation, you’ll “probably be automatically re-enrolled,” according to Healthcare.gov. Not very reassuring, is it? For your peace of mind, just login, follow the directions, and review your information. It doesn’t take long, and you can rest easy knowing your child’s ABA therapy will be covered for next year.

The deadline to enroll (and re-enroll) is December 15.
The Marketplace is a stickler about the deadline. If you want coverage that starts on January 1, you must enroll or re-enroll in a plan by December 15. If for some reason you miss the December 15 deadline, you have until January 15 to enroll for coverage that starts February 1. After that, you’ll have to buy health insurance on your own outside of the Marketplace or go without if you don’t qualify for a Special Enrollment Period.

Your first month’s premium is due when you enroll.
One of the advantages of shopping for health insurance on the Marketplace is you may qualify for savings on your monthly premium. Depending on your annual income, the savings can be significant. That’s another reason to login and review your information and your plan. You could be missing out on savings!

All plans on the Marketplace are required to cover behavioral health treatment.
Behavioral health treatment, like ABA therapy, is considered one of 10 essential health benefits that must be covered in all plans on the Marketplace. However, the extent of benefits can vary by state and the plan you choose. You can see a full list of what each plan covers, including behavioral health benefits, when you compare plans on the Marketplace website. In addition, all Marketplace health plans (and most other private insurance plans) must cover preventive services for children without charging a copayment or coinsurance. This includes autism screening for children at ages 18 and 24 months.

You can buy a child-only plan on the Marketplace.
There are a few circumstances why you might consider a child-only plan.

  • Your employer-provided plan doesn’t cover ABA therapy.
  • You share custody with an ex-spouse that lives in a different state.
  • You’re on Medicare and the guardian of a grandchild, and they don’t qualify for Medicaid or CHIP, the Children’s Health Insurance Program.

Child-only plans are available on the Marketplace for children under the age of 21 with no parent or guardian covered on the same policy. Savings on premiums are available if you qualify. However, if your child has access to an employer-sponsored plan, you will not be eligible for a discounted Marketplace plan.

Need help deciding on a Marketplace plan? Talk with a local agent.
Healthcare.gov provides an easy way to find a local agent in your area to help you decide on the best plan for your needs. Start here and enter your ZIP Code. All agents have been trained and certified by the Marketplace.

Finally, if there’s anything else we can do to help, contact our autism experts today. As a Behavioral Health Center of Excellence®, we provide a holistic approach to ABA therapy that supports families as well as children, including being their insurance advocate.

A brighter future is possible with ABA therapy from The Behavior Exchange!

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Ashvina attended University of Bombay and graduated with a Bachelors of Commerce. She got her Montessori Diploma in 1985 and taught ever since. Ashvina came to TBE in January of 2016 as Admin Assistant. During the years she got the opportunity to learn and work in different departments such as HR, Finance, Office Manager and Executive Assistant. Last summer TBE bought billing in house and her current focus area is Revenue Cycle Management. She is detail oriented and enjoys working with people. Ashvina volunteers to deliver meals to seniors and local shelters on the weekend. She loves to spend time with her family and grandkids. Ashvina loves her job because she enjoys hearing different points of view, and she feels her contributions help fuel the direction of our company.

Working with children comes naturally to Angela. Her mom was a special education teacher for 30 years and often had Angela join her for Take Your Child to Work Day. And in high school, Angela spent every summer as the nanny for a little boy with an autism spectrum disorder. It was this experience where her passion for working with children with autism started to blossom.

From there, she went on to graduate from Oklahoma State University with a Bachelor of Science in Human Development and Family Sciences. She learned about Applied Behavior Analysis (ABA) in a non-normative development class and from that moment knew that ABA would be her life’s work.

Angela moved to the DFW area shortly after and began working at The Behavior Exchange as a therapist. She worked on her Master’s in Behavior Analysis at the same time. A year after graduating, she earned certification as a Board Certified Behavior Analyst.

Now, as a Clinical Director at The Behavior Exchange, she brings a life-long passion to her work, holding a special place in her heart for children with limited language skills and working closely with families to develop healthy sleep habits.

Danielle’s passion for working with families is deeply personal and from the heart. Her younger brother has an autism spectrum disorder, and through their journey as a family, she found her purpose in life as an advocate for individuals with special needs.

After graduating from the University of North Texas with a degree in Human Development and Family Studies, Danielle began volunteering at The Behavior Exchange. She saw passionate therapists, meaningful change for clients, and families with hope for the future. After a summer of volunteering, she officially joined the team as Director of Admissions and found her home with The Behavior Exchange family.

With her extensive experience working as a client advocate with insurance providers, Danielle perseveres to help individuals of all ages and abilities receive the services they need to reach their full potential. She feels truly honored by each and every family who entrusts The Behavior Exchange to be part of their journey and is committed to the organization’s core values, mission, and goal of being a beacon of hope for the community.

Adam has always had a passion for helping individuals of all ages thrive and reach their full potential. He’s also an enthusiastic musician, songwriter, leader, and devoted family man, who has been helping children and team members grow with The Behavior Exchange since 2010.

Prior to joining the team at The Behavior Exchange, Adam was a mortgage loan consultant and grad student, pursuing his master’s degree in Education at the University of North Texas. He graduated in 2013 and also earned a graduate academic certificate in Autism Intervention. The following year, after years as a Behavior Therapist and seeing first-hand the power of ABA and the meaningful impact it can have on children and their families, Adam became a Board Certified Behavior Analyst. He then commenced from the Stagen Leadership Academy after completing the Integral Leadership Program (ILP), a 52-week practice-based program designed to develop executives serious about transforming themselves, their teams, and their organizations.

Adam is truly grateful to be a part of a dynamic, inspiring and compassionate team, and he’s dedicated to bettering the lives of all children and their families through the delivery of the highest quality of ABA services, while supporting the amazing team at The Behavior Exchange.

Soraya is from South Africa and moved to Texas in 1996. She graduated from The University of Texas and pursued a career, at that time, in Education. Soraya taught at a Montessori school for a few years and then took on a leadership role.

During her time in the education system, Soraya realized her passion was to assist children with special needs. So she joined The Behavior Exchange as a therapist, transitioned into a supervisory role in 2017, and a year and a half later, was promoted to Clinical Operations Manager.

She quickly learned the ins and outs of ABA operations and scheduling and successfully collaborates across departments to ensure The Behavior Exchange continues to provide quality services to clients and their families. She’s thankful to be part of such an amazing organization and excited to see what the future holds.

You could say Walter’s career started when he spent hours as a young child drawing superheroes and coloring maps. This passion, along with extraordinary swimming skills, landed him a full swimming scholarship at Texas Christian University, where he graduated in 1997 with a Bachelor of Fine Arts in Communication Graphics.

During the next 13 years, his design and art direction skills, conceptual-thinking abilities, and marketing-savvy know-how were honed at a few prestigious advertising and marketing agencies around the Dallas area. In the mid 2000s, he helped his wife Tammy Cline-Soza (founder and CEO of The Behavior Exchange) create a unique and concise brand for her new business. From logos and websites to uniforms, brand voice and visuals, Walter has been the main creative force for all things The Behavior Exchange.

Aside from giving birth to The Behavior Exchange brand, Walter is helping Tammy raise two amazing, beautiful children, River and Sierra. In his spare time (the two minutes he’s got per week), you can find Walter illustrating iconic landmarks of Dallas and Texas or looking around for this next open-water swim. Once he gets back in shape.

After 20 years of building The Behavior Exchange, literally from the ground up,
Tammy couldn’t be more proud of the team, culture, and organization that it has become.

As a family helping families, The Behavior Exchanges looks for opportunities that will make the biggest impact and produce life-changing outcomes – for clients, families, and even for team members. Tammy believes that if a team, a family, a community takes care of each other, the possibilities are endless and the relationships built along the way can make life more enriching and challenges easier to navigate. You could say her goal has been to build a kind of utopia full of support, love, and expertise that brings the best services possible to the community and ensures more families have access to those services.

Tammy and her family have dedicated their lives to the mission of The Behavior Exchange and continue to grow, learn, cultivate, challenge, support, and create better models for success. To that end, she is committed to her own leadership development and actively participates in advanced training, mentoring, and deep self-exploration on how to live out her purpose to love and support her family and help others reach their full potential. She takes her position very seriously and tries to serve as a channel for what the universe wants to come to fruition.

She also loves travel, gardening, being creative, MUSIC!, tennis, yoga, meditation, journaling, reading, being in nature, adventures, and more than anything, spending time with her husband Walter and their two beautiful children, River and Sierra.