If you’re a parent or caregiver navigating an autism diagnosis in New York, you might wonder:
“Will Medicaid help cover the costs of ABA therapy?”
The short answer is: Yes, Medicaid does cover ABA therapy in New York — but there are important details you should know to make sure your child receives the right support.
In this guide, we’ll walk you through exactly how it works, what to expect, and how ABC Achieve can help you every step of the way.
What is ABA Therapy?
Applied Behavior Analysis (ABA) is a proven, evidence-based therapy that helps children with autism develop critical skills like communication, social interaction, and independence.
ABA therapy is widely recognized as one of the most effective treatments for autism spectrum disorder (ASD).
Does New York Medicaid Cover ABA Therapy?
Yes. As of 2022, New York State Medicaid and most Medicaid Managed Care Plans are required to cover ABA therapy for eligible children.
Whether your child has straight Medicaid or is enrolled through a Managed Care plan, there are options available to access ABA services.
Who is Eligible?
Your child may qualify for Medicaid-covered ABA therapy if:
- They have a formal autism diagnosis from a licensed professional.
- They are enrolled in a New York State Medicaid program (including Managed Care).
- The therapy is deemed medically necessary.
Important:
Some Medicaid plans may have different rules or requirements. It is always a good idea to check specific plan details and that is where our team at ABC Achieve can help you verify everything quickly.
How Do I Start ABA Therapy with Medicaid?
Here’s a simple roadmap:
- Get a Diagnosis:
A formal autism diagnosis from a licensed psychologist, neurologist, or developmental pediatrician is required. - Obtain a Referral:
Some Medicaid plans require a referral or prescription from your child’s primary care doctor. - Choose an Approved Provider:
The provider must be credentialed with Medicaid or your specific Managed Care plan. - Start the Intake Process:
Contact the provider (like ABC Achieve) to schedule assessments and begin therapy planning.
Read More: Navigating Insurance for ABA Therapy: A Guide for Families
Does ABC Achieve Accept Medicaid?
Yes, we work with families covered under New York Medicaid and many Managed Care Plans.
At ABC Achieve, we help families verify insurance benefits, handle paperwork, and start services as soon as possible because we understand how important early intervention is.
Even if you are not sure about your eligibility, our team can guide you through checking and securing the right coverage.
Common Questions Families Ask
1. Does Medicaid cover the full cost of ABA therapy?
Usually, yes.
Most Medicaid plans cover ABA services 100% with no out-of-pocket costs for eligible families. However, some plans might have limits or require prior authorizations.
2. What if I have Medicaid Managed Care?
Many Managed Care plans (such as Fidelis, Healthfirst, and UHC Community Plan) cover ABA therapy. We will help confirm whether your plan includes coverage and guide you through any steps needed.
3. Can I choose where my child gets ABA therapy?
In most cases, yes. Options may include home-based services, center-based therapy, or a combination, depending on your Medicaid plan and provider availability.
How ABC Achieve Makes It Easy for Families
At ABC Achieve, we have supported hundreds of New York families through the Medicaid approval process for ABA therapy.
We know the paperwork, the plans, and the small details that can delay care so we streamline everything for you.
Here’s how we help:
- Free insurance verification
- Fast-tracked eligibility checks
- Flexible scheduling options (home and center-based)
- Compassionate, family-centered care from Day 1
Ready to Get Started?
If you are wondering whether your child qualifies for Medicaid-covered ABA therapy, do not wait.
The earlier you start, the better the outcomes for your child.
Contact ABC Achieve Today — Our team is here to answer your questions, verify your benefits, and help you take the first steps toward life-changing therapy. Check Your Eligibility Now
