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Insurance

Insurance coverage varies widely.

 

While most plans cover evaluations, coverage for treatment sessions can differ based on diagnosis and your employer's plan. Your employer's insurance plan might cover or exclude specific diagnoses and set limits on annual sessions. Therefore, whether your child receives therapy in-network or out-of-network may not affect coverage.

Regardless of your insurance, your child's therapy shouldn't be delayed. Early intervention is key for effective treatment.

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Speech, Physical, & Occupational Therapy

In-Network:​

  • Aetna PPO
  • Cigna PPO
  • Blue Cross/Blue Shield of Texas (All Plans EXCEPT Affordable Care Act)
  • City of San Antonio Employees (if under Texas True Choice)
  • Texas True Choice
  • Supplemental Special Education Services (SSES)
  • All Tricare Plans *
  • United Healthcare PPO

 

Out-of-Network:

  • Aetna HMO
  • Cigna HMO
  • United Healthcare HMO

 

ABA Services

In-Network:

  • Blue Cross/Blue Shield of Texas (All Plans EXCEPT Affordable Care Act)
  • All Tricare Plans *

* Visit Tricare's Check Eligibility page if you're unsure whether you qualify! Please note that we are in-network with Tricare, although we sometimes don’t appear on their list of providers.

Humana is the ONLY plan we do NOT accept (even on an out-of-network basis). If your insurance (excluding Humana) isn't listed but you're in a PPO, please contact us and we’ll verify if services can be covered out-of-network. We strive to serve everyone!

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Nonemergency medical transportation services are accessible for Medicaid beneficiaries and their children, covering rides to healthcare facilities such as doctor's and dentist's offices, hospitals, pharmacies, and other relevant locations.

Types of rides include:

  • Public transportation (i.e., city bus)
  • Taxi or van services
  • Commercial transit (like a bus or plane) for appointments in other cities

Additional services may include:

  • Gas money
  • Meals and lodging for individuals under 20 staying overnight for healthcare services
  • Partial payment for out-of-state travel to neighboring states (Louisiana, Arkansas, Oklahoma, and New Mexico)

Services do not include arranging emergency or nonemergency ambulance transportation.

Eligibility:

To qualify for transportation services, individuals must be enrolled in one of the following programs and not have any other means of transportation:

Booking a Ride:

  1. Schedule an appointment with your healthcare provider.
  2. Request a ride at least two workdays before the appointment (or five days if outside your county), between 8 a.m. - 5 p.m. on Monday through Friday.
    • Same-day rides may be arranged for urgent medical needs or immediate post-hospital discharge.
    • For Medicaid health plan members, contact your health plan’s medical transportation number.
    • If uninsured, call 877-633-8747 (877-MED-TRIP).

Travel Guidelines for Minors:

  • Children under 14 must travel with a parent or guardian.
  • Children aged 15-17 may travel alone with written parental permission.

Required Information for Booking:

When requesting a ride, please have:
  • Medicaid ID or Social Security number
  • Name and contact information of the medical professional you or your child are seeing
  • Address and phone number of appointment location
  • Address and phone number of pickup location
  • Appointment details (date, time, reason for visit)
  • Any special requirements like wheelchair accessibility
  • Confirmation that no other transportation means are available

Gas Assistance and Alternative Drivers:

If you have a car but lack gas money, contact for assistance as outlined above. Medicaid can cover gas expenses through the Individual Transportation Participant (ITP) program.
 
Additionally, Medicaid may reimburse friends, relatives, or neighbors who drive you or your child to appointments if they join the ITP program, given that all drivers have a valid driver’s license, license plates, inspection sticker, and car insurance.
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