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Autism Care Demonstration: Benefits

Through the Autism Care Demonstration (ACD), beneficiaries have access to applied behavior analysis (ABA) services and, for beneficiaries new to the ACD as of Oct. 1, 2021, Autism Services Navigators (ASNs).

Visit www.tricare.mil/autism and www.tricare.mil/isitcovered for full TRICARE benefit details.

Applied Behavior Analysis 

ABA is a type of service that focuses on specific behaviors that affect individuals with autism spectrum disorder (ASD). The overall goal of ABA is to decrease challenging/interfering behaviors and teach appropriate replacement behavior to improve quality of life for the beneficiary and their family and caregivers, ultimately reducing or eliminating the need for direct services.

Strategies used in ABA include but are not limited to:

  • Shaping behavior patterns through reinforcement and consequences
  • Differential schedules of reinforcement
  • Discrete trial teaching
  • Natural environmental training
  • Pivotal response training

Not all strategies may be implemented for every beneficiary. ABA services are authorized and rendered under the ACD according to the patient’s individual needs as determined by assessments and treatment progress.

ABA is most effective when family members/caregivers actively participate by consistently reinforcing ABA interventions in the home setting per the developed treatment plan.


What to Expect in an ABA Program

An ABA program includes: 

  • Initial treatment assessments 
  • Development of a treatment plan with specific goals to be addressed in treatment that is updated every six months
  • Completion of outcome measures
  • One-on-one ABA services
  • Training immediate family members on ABA techniques
  • Ongoing modifications based on the progress of treatment plan goals, outcome measures and parent/caregiver engagement 

There is no minimum or maximum age limit or duration limit. All services are authorized based on clinical necessity.

Autism Services Navigators 

On Oct. 1, 2021, TRICARE introduced the ASN role to the ACD. 

To be eligible for an ASN, you must be new to the ACD as of Oct. 1, 2021. You also may be eligible for an ASN if you were enrolled in the ACD before Oct. 1, 2021, but there was a gap in ABA services that lasted longer than 12 months. 

Learn more on our Autism Services Navigators page.

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