TRICARE Coverage for Autism-Related Services
As the healthcare program serving active duty service members, retirees and their families worldwide, TRICARE is a major component of the military health system. TRICARE brings together the healthcare resources of the uniformed services and supplements them with networks of civilian healthcare professionals, institutions, pharmacies and suppliers. This results in access to high-quality healthcare services and maintains the capability to support military operations.
Autism-related behavioral health services are covered by TRICARE, based on the following demonstration of eligibility. The covered individual must be:
- 18 months and older
- Registered in the Extended Care Health Option (ECHO)
- Diagnosed with one of the following:
- Autism Disorder (AD)
- Childhood Disintegrative Disorder (CDD)
- Asperger’s Syndrome (AS)
- Pervasive Developmental Disorder Not Otherwise Specified (PDDNOS)
Note: If diagnosed before this demonstration requirement began (March 15, 2008), children do not need to be re-diagnosed.
To see if your child may qualify, please contact your regional contractor and discuss your options with your primary care provider.
The types of services covered by TRICARE under its Educational Interventions for Autism Spectrum Disorders (EIASD) guidelines align perfectly with the approach and expertise that you will find at Trumpet Behavioral Health. Specifically, services are covered that:
- Implement basic principles of Applied Behavior Analysis (ABA) and target behaviors associated with the core deficits of Autism Spectrum Disorders (ASDs);
- Focus on changing the child’s behavior by observing and measuring the behavior in real-life environments;
- Use scientific behavioral data to identify functional relationships between environmental events and behavior;
- Gather behavioral data to track progress in reaching behavioral objectives identified in the Behavior Plan, and periodically modify the plan to adapt to the child’s response to the intervention;
- Incorporate parent training so family members/caregivers can teach and support skills during typical family activities; and
- Require meetings between family members/caregivers and those designing and implementing the intervention program.
As a TRICARE-authorized behavioral services provider, Trumpet Behavioral Health looks forward to serving you and your family with our evidence-based, compassionate approach to autism treatment and therapy.
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