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.
No Insurance? No Problem
We believe in making ABA therapy accessible for all families, regardless of insurance coverage. We offer sliding-scale financial assistance options to help parents afford the care their child needs. Contact us and we will gladly review your situation and work with you to find the best possible solution
ABA therapy for autism: Benefits by state
At ABC, we serve children with autism and their families in Texas, Arizona, Colorado, Illinois, Minnesota, and North Carolina. Every U.S. state has laws that mandate health insurance plans 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).
We work with most major insurance providers at all our center locations. At this time, we do not accept Medicaid at our Texas, Illinois, Minnesota, or North Carolina centers.
Texas
Texas law requires insurance companies to cover all generally recognized autism-related services prescribed by the child’s primary care physician (PCP) from the date of autism diagnosis until the child’s tenth birthday.
Arizona
Arizona's "Steven's Law," enacted in 2008, aimed to ease the financial strain on families by ensuring access to quality services for children with autism spectrum disorder (ASD). This mandate requires insurance to pay for children’s autism diagnosis, assessment, and treatment services until age 16.
Colorado
Colorado’s Senate Bill 09-244 requires most major insurance plans to provide autism assessments, diagnoses, and treatment services for children.
Illinois
An Illinois legislation mandates certain health insurers to cover the diagnosis and treatment of autism spectrum disorder for individuals under 21 years old. Treatment includes therapeutic services like ABA therapy.
Minnesota
A Minnesota law mandates that health plans issued to large employers must provide coverage for children with autism age 18 and younger. This law covers early intensive behavioral interventions, ongoing evaluation, and services like ABA therapy.
North Carolina
A North Carolina law mandates that health benefit plans must offer coverage for autism spectrum disorder screening, diagnosis, and treatment, including ABA therapy.
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. Allow us to help you understand the costs associated with ABA therapy, which is no-cost for many families.
- 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.
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?
Yes! We never want cost to be a factor in preventing a child from receiving ABA therapy. We offer sliding-scale payment options for those who qualify.
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.
