Definition
“Eligibility” in the context of this encyclopedia refers to qualification to receive reimbursement for or benefits from a variety of private and public programs.
Historical Background
Eligibility issues regarding ASD patients may present in private health care insurance, public health care insurance, education, disability benefits, and antidiscrimination contexts.
Current Knowledge
Private Health Care Insurance
Treatment for ASD can be costly, with annual expenses exceeding $50,000 (NCSL) and mean lifetime care expenses totaling $3.2 million (Ganz, 2006). As a result, eligibility for private health insurance coverage for ASD-related treatment can be important to people with ASD and their families.
Insurance coverage is especially difficult to obtain for behavioral therapies such as Applied Behavioral Analysis therapy (ABA). Kaiser Permanente, for example, classifies ABA therapy as educational rather than clinical treatment and, thus, denies insurance reimbursement for its...
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Thomas, J.W. (2013). Eligibility (for Services Under IDEA/ADA, etc.). In: Volkmar, F.R. (eds) Encyclopedia of Autism Spectrum Disorders. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-1698-3_1957
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