Insurance coverage & financial assistance
Navigating insurance coverage for your child with autism can be overwhelming. At Action Behavior, our knowledgeable insurance specialists work directly with your insurance company so you can focus on what truly matters—supporting your child.
Action Behavior Centers accepts most insurance providers:
Allow us to do the heavy lifting.
Here’s how Action Behavior Centers can help your family.
- We call your insurance company to verify your child’s ABA therapy coverage, deductible information, and any out-of-pocket costs you may be responsible for.
- If needed, we complete pre-authorization paperwork. In this process, the therapy provider seeks approval for insurance coverage from an insurance company by verifying that treatment is necessary.
- After working with your child, we bill the insurance company directly for the services provided.
Action Behavior is proud to be in-network with the largest health insurers in the states we serve. The insurances we have worked with in the past include:
- Blue Cross Blue Shield
- Aetna
- United Healthcare
- Cigna
- Ascension
- Optum
- UMR
- PHCS
- Beacon Health
- Options
- Medica
We are adding more each day, so please call us to discuss your specific plan. At this time, we do not accept Medicaid at our Texas, Illinois, or Minnesota ABA therapy centers.
ABA therapy for autism: Benefits by state
At ABC, we serve children with autism and their families in Arizona, Colorado, Connecticut, Florida, Georgia, Illinois, Indiana, Kentucky, Minnesota, Missouri, Nevada, North Carolina, Ohio, Pennsylvania, Texas, and Virginia.
Every U.S. state has laws that mandate health insurance plans to cover autism-related services for children. The extent of these services varies by state, and exceptions may apply for consumer choice or small-business plans (50 or fewer employees.)
Arizona
In Arizona, the "Arizona Autism Mandate" requires insurance plans to cover the diagnosis and treatment of autism, including ABA therapy, ensuring individuals with autism have access to necessary therapies.
Colorado
Colorado’s 2009 Senate Bill 09-244 requires most major insurance plans to provide diagnostic support and treatment for children with autism. In 2015, Senate Bill 15-015 removed all age and dollar caps on autism care, including for applied behavior analysis services.
Connecticut
Connecticut’s 2009 autism insurance bill, Substitute Senate Bill 301/Public Act 09-115, provides comprehensive autism coverage for children. Services covered by this law include diagnostic support, behavioral therapy like ABA, speech therapy, occupational therapy, and physical therapy.
Florida
Senate Bill 2654 was enacted in 2008 in Florida. Under this law, if a child is diagnosed with autism spectrum disorder before age 8, they are eligible to receive ABA therapy and other services.
Georgia
Georgia’s autism insurance bill, Senate Bill 118, was passed in 2015. It covers the following autism-related services for individuals under 21 years old: diagnosis support; applied behavior analysis; counseling services; and speech, occupational, and physical therapy.
Illinois
Public Law 095-1005 in Illinois mandates certain health insurers to cover the diagnostic support and treatment of autism spectrum disorder for individuals under 21 years old. Treatment includes therapeutic services like ABA therapy.
Indiana
Indiana’s autism insurance bill, IC-27-8-14.2, was enacted in 2001 and covers autism-related treatment that is prescribed by a qualified physician as part of a comprehensive treatment plan.
Kentucky
Kentucky’s House Bill 159 was enacted in 2010. In 2018, it was amended to remove age and dollar caps on ABA coverage (House Bill 218). Coverage in Kentucky is extensive and includes the following: autism diagnostic support; ABA therapy; medical, pharmacy, psychiatric, and psychological care; and speech, occupational, and physical therapy.
Minnesota
Minnesota’s autism insurance bill, HF 1233, was enacted in 2013 and covers individuals with autism under 18 years of age. Under this law, young people with autism can receive diagnostic support and assessment services, early intensive behavioral interventions like ABA therapy, and therapeutic services like speech therapy.
Missouri
Minnesota’s autism insurance bill, HF 1233, was enacted in 2013 and covers individuals with autism under 18 years of age. Under this law, young people with autism can receive diagnostic support and assessment services, early intensive behavioral interventions like ABA therapy, and therapeutic services like speech therapy.
Nevada
In Nevada, individuals under the age of 18 can receive autism screening and diagnosis services, ABA therapy, psychiatric care, and speech, occupational, and physical therapy under Assembly Bill 162.
North Carolina
North Carolina’s autism insurance bill, Senate Bill 676, was enacted in 2015 and covers behavioral therapy and other therapeutic services for individuals with autism under 19 years old.
Ohio
Ohio’s autism insurance bill, House Bill 463 (Sec. 1751.84), was enacted in 2017 and covers speech and occupational therapy, ABA therapy, and outpatient mental health services for people with autism under age 21.
Pennsylvania
House Bill 1150 in Pennsylvania became effective in 2009. It covers diagnostic support, ABA therapy, pharmacy care, psychiatric care, and other therapeutic services for individuals with autism under 21 years old.
Texas
SB 946, the autism insurance bill in Texas, requires insurance companies to cover all generally recognized autism-related services prescribed by the child’s primary care physician (PCP) so long as the autism diagnosis was made before the child’s tenth birthday.
Financial assistance for ABA therapy
At Action Behavior, we believe that every child should have access to the benefits of ABA therapy, regardless of their family’s financial situation. Our sliding-scale options are designed to help families pay what they can afford based on their income level.
- Maximum out-of-pocket (MOOP) expenses are the most amount of money your family has to pay for healthcare expenses in a given year before your insurance covers the rest.
- Paying MOOP expenses can be a significant burden for some families, and we are committed to helping ease this financial stress.
Allow us to help you understand the costs associated with ABA therapy, which is little to no cost for many families.
FAQs about insurance
View all FAQs
Does insurance cover ABA therapy?
Most health insurance plans cover ABA therapy, and we are proud to be in-network with the largest health insurers in our service areas. At ABC, our insurance specialists handle the details, so you don’t have to. We verify your child’s ABA therapy coverage, complete any necessary pre-authorization paperwork, and directly bill the insurance company for services.
How much does ABA therapy cost?
All private commercial health insurance companies in the United States and Medicaid cover ABA therapy to some degree. Health insurance can be a tricky road to navigate, which is why our staff will check your insurance eligibility for you. We will provide you with information regarding out-of-pocket costs, how many hours of ABA therapy your insurance covers, and how many hours we recommend your child needs.
Patient responsibility refers to the total amount a patient must pay out of their own pocket. This may include copayments or coinsurance for insured patients. Families who are paying for ABA therapy often find insurance covers most or sometimes all of the expense, particularly once the family has met their deductible or maximum out-of-pocket amount for the year.
Can I just make a copay for ABA therapy like I do at the doctor’s office?
If you have a copay or coinsurance, you can pay online through our easy-to-use patient portal. During the admissions process, we will provide you with a fee schedule and an estimate of your anticipated out-of-pocket expenses for ABA therapy.
Do you offer financial assistance for ABA therapy?
We believe all children should have access to life-changing ABA therapy regardless of their family’s financial situation. That’s why we offer sliding-scale options so families can pay an amount that aligns with their income.
We also understand that meeting your maximum out-of-pocket (MOOP) costs can be overwhelming. MOOP refers to the highest amount your family is required to pay for covered healthcare services in a year before your insurance covers 100% of additional costs.
If you're concerned about the cost of ABA therapy, we’re happy to discuss your insurance benefits and explore ways we can help reduce the financial burden. Many families qualify for ABA therapy at little to no cost.
Prepare them for a bright future with ABA therapy
Start ABA therapy today. Our online interest form helps us match you with a center near you. We will be in touch soon.
