If you’re a parent or caregiver of a child with autism in New York, understanding insurance coverage for ABA therapy can feel overwhelming. But you’re not alone and the good news is that many health insurance plans in New York now cover ABA (Applied Behavior Analysis) therapy, making it easier for families to access the support they need.
In this guide, we’ll break down which types of insurance typically cover ABA therapy in New York, how the process works, and what steps you can take to get started. We’ll also link you to more detailed articles about specific insurance providers and coverage options.
What Is ABA Therapy and Why Is It Important?
ABA therapy is a science-backed treatment for autism that focuses on helping children develop essential life skills like communication, social interaction, and behavior regulation. It’s widely recognized as one of the most effective treatments for individuals with autism spectrum disorder (ASD).
ABA therapy can take place at home, in schools, or in a center-based environment. The goal is to provide consistent, personalized support to help your child thrive in everyday situations.
What Types of Insurance Cover ABA Therapy in NY?
In New York, both private insurance plans and Medicaid may provide coverage for autism-related services, including ABA therapy. However, coverage can vary depending on your provider, plan type, and whether your therapy center is in-network.
Here are the main types of insurance that often cover ABA therapy in New York:
1. Private Health Insurance (Commercial Plans)
Thanks to state laws and the federal Affordable Care Act (ACA), many private insurance plans must cover medically necessary autism treatments, including ABA therapy.
Common providers in New York that offer ABA therapy coverage include:
- Anthem Blue Cross Blue Shield – Learn more about Anthem autism services NY
- Aetna
- Cigna
- UnitedHealthcare
- Empire BlueCross
- MVP Health Care
Each plan has its own requirements, such as prior authorizations, approved diagnosis, and in-network providers. Be sure to check your specific plan or call your provider for details.
Approximately 54.3% of children and youth with special health care needs in New York are covered exclusively by private insurance. (Source: New York State Department of Health)
2. Medicaid (Including Managed Care Plans)
New York State Medicaid also covers ABA therapy for eligible children under 21 years old through the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) program.
If your child is enrolled in a Medicaid Managed Care plan, you’ll need to work with a provider who accepts that plan. Some managed care organizations include:
- Fidelis Care
- Healthfirst
- MetroPlus Health Plan
You can talk to your caseworker or ABA provider to help navigate your Medicaid benefits.
Check Out Our Post: Does Medicaid Cover ABA Therapy in New York?
Autism Insurance Reform in New York
New York passed an autism insurance reform law in 2012 that requires many insurance policies to cover autism treatment, including up to 680 hours of ABA therapy per year. This law applies to most group and individual plans issued in New York.
This is a huge win for families seeking support, as it helps ensure more consistent access to evidence-based autism treatment like ABA therapy.
What to Do Next
If you’re just getting started:
- Call your insurance provider and ask specifically about “ABA therapy coverage for autism treatment.”
- Ask your ABA provider to help you verify benefits. Many centers, like ours, offer support with insurance verification and authorizations.
Need Help Navigating Insurance?
We understand that insurance paperwork can be stressful—especially when you’re focused on helping your child. Our team is here to help you every step of the way.
We’ll:
- Verify your insurance benefits
- Explain your coverage clearly
- Work with your provider to get the necessary approvals
Whether you’re working with UnitedHealthcare ABA Therapy in NY, Medicaid, or another provider, we’re committed to helping your child get the support they deserve.
Final Thoughts
Accessing ABA therapy insurance in NY is easier today than it was just a few years ago—but it still takes some research and patience. Understanding your insurance coverage is the first step toward giving your child the tools they need to grow, learn, and thrive.
Want help getting started? Contact us today and let’s walk through your options together.
Children who received at least 20 hours of ABA therapy per week demonstrated a 48% greater improvement in adaptive behavior scores over a 12-month period compared to those receiving fewer hours. (Source: PMC)
