Medicaid Covers ABA Therapy in Illinois
If your child is on Medicaid and you've been told to wait, there's a path forward that most families don't know exists. Dr. Lapin walks families through it every year, and it starts with a single conversation.
If your child is on Medicaid and you've been told to wait, there's a path forward that most families don't know exists. Dr. Lapin walks families through it every year, and it starts with a single conversation.
A "yes" on paper isn't always a "yes" in practice.
If your child is on Medicaid, you may have already been told the good news: ABA therapy is covered. And it's true. In Illinois, Medicaid only recently began covering ABA at all — a real and meaningful step forward. But for most families, that coverage hasn't translated into actual care, and ChoicePoint would rather be honest with you about why than let you find out the hard way.
Although Medicaid technically covers ABA therapy in Illinois, the way the plan is currently structured places significant constraints on providers — enough that many practices, ChoicePoint included, are not able to accept it. Only a small handful of providers in the state take Medicaid at all. And those few carry waitlists so long that families end up exactly where they started: a child who needs services now, and no real way to begin.
We say this plainly because pretending otherwise helps no one. A covered service you can't access isn't access. It's a waiting room.
Here is the part that changes the story.
Every year during open enrollment, Dr. Lapin and a dedicated insurance broker partner sit down with families and help them apply for a private insurance plan for their child through the Affordable Care Act — just the child, not the entire household.
And this is the piece families are most surprised to learn: your child does not lose Medicaid. The new plan becomes their primary insurance, and Medicaid stays in place as secondary coverage. Nothing is given up. A door is simply added.
From there, Dr. Lapin applies on your behalf for a specific Illinois grant designed to cover most of the cost of that private plan. So the path that finally opens the door to care doesn't come with a price tag your family can't manage.
This approach means a child can start services immediately — no waitlist. It means a family is no longer forced to accept the one provider who happens to take Medicaid, whether or not that provider is the right fit for their child. It means choice, and it means now instead of someday.
Dr. Lapin personally guides roughly 20 to 40 families through this process every year. It is one of the things ChoicePoint is most proud of, because it turns a coverage technicality into real, hands-on care.
This can only happen during open enrollment, which runs November 1st through December 15th. That is the single window each year when ChoicePoint can help a family on Medicaid move onto a private plan for their child.
If your child is on Medicaid and you've felt stuck, please don't wait for the deadline to sneak up. Reach out, and Dr. Lapin will make sure you're ready when the window opens.
The answers below cover what families on Medicaid ask most about coverage, waitlists, the ACA path forward, and what ChoicePoint can do to help during open enrollment. If your situation feels different, send us a message and Dr. Lapin will get back to you personally.
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