ABA Therapy Centers in Michigan

Medicaid autism benefit through your PIHP and CMH

Michigan Medicaid covers behavioral health treatment, including ABA, for beneficiaries under 21 with an autism diagnosis from a qualified licensed practitioner. The PIHP handles the diagnostic evaluation if your child has no diagnosis yet, then the behavioral assessment and the ABA itself. Call the access line for your county's CMH, which sits inside one of ten PIHP regions. A child who cannot enroll in a PIHP goes to a Medicaid Health Plan or fee-for-service Medicaid instead.

• Wayne County and Detroit: Detroit Wayne Integrated Health Network, access line 800-241-4949.
• Oakland County: Oakland Community Health Network, access line 800-341-2003.
• Macomb County: Macomb County CMH Services, access line 855-996-2264.

Insurance Code 500.3406s and private plans

Section 3406s of the Insurance Code requires insurers to cover autism diagnosis and treatment, including behavioral health treatment supervised by a board certified behavior analyst. The Department of Insurance and Financial Services says this reaches individual plans and fully insured group plans issued in Michigan, and that insurers cannot apply age limits or annual dollar limits. The statute text still lets insurers cap annual benefits through age 18 ($50,000 to age 6, $40,000 for ages 7 to 12, $30,000 for ages 13 to 18), so ask your plan to confirm its limits in writing.

Children's Waiver Program and Habilitation Supports Waiver

The Children's Waiver Program (CWP) lets Medicaid pay for home-based supports for children under 18 with a developmental disability and a need for daily in-home help. Parent income is not counted. You request an assessment from your county CMH, and when a slot opens MDHHS invites eligible children to apply. The state serves 669 children a year and fills openings monthly, so ask the CMH about timing. The Habilitation Supports Waiver covers people with intellectual or developmental disabilities who meet an institutional level of care.

Early On for children from birth to three

Early On is Michigan's early intervention system for infants and toddlers from birth to three years old with a disability, a developmental delay or an established condition. The Michigan Department of Lifelong Education, Advancement, and Potential (MiLEAP) runs the program as the state lead agency under Part C of IDEA. Call 1-800-EarlyOn (800-327-5966) or complete the online referral form. You can refer while you wait for a clinic intake.

Licensed behavior analysts in Michigan

Michigan licenses behavior analysts and assistant behavior analysts under the Public Health Code (MCL 333.18253). Medicaid policy names the board-certified and licensed behavior analyst (BCBA/LBA) and the licensed assistant behavior analyst (BCaBA/LABA) as the practitioners in PIHP networks. Ask any provider for both the BACB certification and the Michigan license number before you start services.