ABA therapy and Tricare

What is covered

Tricare covers ABA when it is medically necessary, subject to the program's own authorization rules.

ABA for Tricare families is delivered through the Autism Care Demonstration, which is a separate program from the standard Tricare medical benefit. It has its own referral, enrollment and outcome-measure requirements.

Ask them: Do I have an ACD referral on file, and which regional contractor handles it?

Self-funded or fully insured?

Ask your employer which yours is. Fully insured plans follow your state's autism mandate; self-funded plans follow federal rules instead. Many cover ABA either way.

Before your first session

• Confirm the agency is in network, not just willing to bill.
• Ask how many authorized hours, over what dates.
• Ask your copay per session.
• Get the reauthorization date in writing.