We simplify insurance for ABA therapy
Alpaca Health is proud to partner with many of the largest health insurers in the states we serve. Most families find that their coverage includes ABA therapy for autism spectrum disorder (ASD), and we’re here to help guide you every step of the way.
Insurance verification
We call your insurance company to verify your child’s ABA therapy coverage, deductible information, and any out-of-pocket costs.
Pre-authorization support
If required, we submit all paperwork to your insurance provider to confirm medical necessity for ABA therapy.
Direct billing
After each ABA therapy session, we submit claims directly to your insurance company for hassle-free payment.
Medicaid
ChampVA
Baylor Scott White Plan
Managed Health Services
Get ABA Therapy Covered by Insurance with Alpaca Health
Alpaca Health completely handles the process of dealing with insurance, so you don’t have to.
Insurance companies often use multiple plan names. To make things easier, here are the common variations we see. This list isn’t exhaustive and is updated periodically as plans change.
- CHAMPVA (Civilian Health and Medical Program of the Department of Veterans Affairs)
- CHAMPVA – Colorado
- VA CHAMPVA
- Veterans Affairs CHAMPVA
- VA Health Administration Center – CHAMPVA
- CHAMPVA for Dependents and Survivors
- CHAMPVA for Children
- CHAMPVA Family Coverage
- CHAMPVA Standard Program
- CHAMPVA Supplement Plan (Private Add-On)
- CHAMPVA with TriWest Provider Network (Colorado)
- VA Community Care Network (CCN) – Region 4 (TriWest)
- CHAMPVA Behavioral Health Network
- CHAMPVA for Spouses and Children of Disabled Veterans
- CHAMPVA for Families of Deceased Veterans
- VA Health Benefits – CHAMPVA Program
- CHAMPVA – Autism and ABA Services (via CCN)
- VA Community Care – CHAMPVA Authorizations
- TriWest / CHAMPVA Provider Network
- CHAMPVA Colorado – Family Eligibility
- Baylor Scott & White Health Plan
- BSW Health Plan – Texas
- BSW Elite Gold (Marketplace)
- BSW Prime Silver (Marketplace)
- BSW Savers Bronze (Marketplace)
- BSW Vital Bronze (Marketplace)
- BSW Plus HMO (Employer Plan)
- BSW Plus PPO (Employer Plan)
- BSW Access PPO (Employer Plan)
- BSW Preferred PPO (Employer Plan)
- BSW Health Plan Individual & Family Plans
- BSW Employer Group Plans – Small Business
- BSW Employer Group Plans – Large Employer
- BSW Marketplace Gold, Silver, Bronze Tiers
- BSW Individual & Family HMO Options
- BSW Individual & Family PPO Options
- BSW Marketplace HSA / HDHP Compatible Plans
- BSW Individual & Family Telehealth Enabled Plans
- BSW Health Plan Coverage for Children & Dependents
- BSW Health Plan Wellness & Preventive Coverage
- Aetna Health Network Only
- Aetna Health Network Option
- Choice POS / Choice POS II
- Choice POS II (Formerly Coventry OAP)
- Elect Choice HMO (includes Aetna Health Funds)
- HMO / POS / EPO / PPO
- Managed Choice Open Access PPO
- Managed Choice POS
- National Advantage Program (NAP) PPO
- Open Access Aetna Select
- Open Access Elect Choice (includes Aetna Health Funds)
- Open Access HMO
- Open Choice PPO
- Open Choice PPO (SOI / Out-of-State)
- QPOS (Quality Point-of-Service)
- Select (Employer / Small Group)
- Signature Authority (ASA or SRC PPO)
- Upfront Advantage
- Aetna Choice POS II (Employer Plan)
- Aetna Open Access Managed Choice
- Cigna Commercial
- Cigna Healthcare of Colorado
- Cigna Open Access Plus (OAP)
- Cigna LocalPlus
- Cigna Preferred Provider Organization (PPO)
- Cigna Point of Service (POS)
- Cigna Open Access Plus In-Network (OAPIN)
- Cigna HMO / EPO / POS
- Cigna Connect (Colorado Marketplace)
- Cigna Individual and Family Plans (ACA Marketplace)
- Cigna SureFit Colorado
- Cigna HealthCare of Colorado – Employer Plan
- Cigna LocalPlus Colorado Network
- Cigna Open Access (National Network)
- Cigna Choice Fund (HSA / HRA)
- Cigna Health Flex Plan
- Cigna Connect Network (Front Range)
- Cigna Behavioral Health / Autism Coverage
- Colorado Connect powered by Cigna
- Cigna + Oscar (Small Business Plan)
- Anthem Blue Cross and Blue Shield (Colorado)
- Anthem BCBS of Colorado
- Anthem Pathway / Pathway HMO
- Anthem Pathway X (Individual & Family ACA Plans)
- Anthem Pathway PPO
- Anthem Blue Priority PPO
- Anthem Blue Access PPO
- Anthem HMO Colorado
- Anthem POS / POS Plus
- Anthem Blue Preferred HMO
- Anthem Individual and Family Plans (ACA Marketplace)
- Anthem Small Group / Employer Plans
- Anthem Blue Choice PPO
- Anthem Blue Priority HMO
- Anthem HealthKeepers (Colorado Network)
- Anthem Select PPO
- Anthem Pathway Essentials
- Anthem Blue Preferred Plus
- Anthem Behavioral Health / Autism Network
- Anthem Pathway X Guided Access
- Health First Colorado (Medicaid)
- Colorado Medicaid
- Health First Colorado – Child & Family Coverage
- Health First Colorado – EPSDT (Well-Child / ABA)
- Health First Colorado Behavioral Health
- Health First Colorado Managed Care Plan
- Rocky Mountain Health Plans – Health First Colorado
- Colorado Access – Health First Colorado
- Kaiser Permanente – Health First Colorado
- UnitedHealthcare – Health First Colorado
- Child Health Plan Plus (CHP+)
- Colorado Child Health Plan (CHP)
- Medicaid Buy-In Program for Children with Disabilities
- Medicaid Buy-In Program for Working Adults with Disabilities
- Home and Community-Based Services (HCBS) Waiver
- HCBS Children’s Extensive Support (CES) Waiver
- HCBS Children’s Habilitation Residential Program (CHRP) Waiver
- HCBS Children’s Home and Community-Based Services (CHCBS) Waiver
- Colorado Youth Mental Health Treatment Act (CYMHTA)
- Health First Colorado Autism / ABA Services
Find ABA Therapy Covered by Insurance Near You
Many insurance plans work across state lines, and we serve families nationwide. Select your state below to confirm network availability and learn about providers in your area. We'll verify your benefits and help you get started with personalized ABA therapy.
States We Serve
Explore our coverage areas and find providers near you
Top Cities We Serve
Quick access to our most popular locations
FAQs About ABA Insurance
Do we need a diagnosis for ABA therapy to be covered by insurance?
In most cases (with some exceptions, such as Colorado Medicaid), insurance plans require a formal diagnosis of Autism Spectrum Disorder (ASD) from a qualified provider—such as a developmental pediatrician, neurologist, psychologist, or psychiatrist—before ABA therapy can be covered. Without this diagnosis, insurers typically do not consider ABA therapy medically necessary.
Do I need a referral for ABA therapy to be covered?
Sometimes. Certain insurance plans require a referral from your child’s primary care physician or pediatrician, while others allow you to go directly to an ABA provider. We can check your specific plan’s requirements during verification of benefits.
Does ABA therapy coverage require a prior authorization?
Almost always. Prior authorization means your insurance company must review and approve the treatment plan before services can start. Our team handles this process for you, submitting the necessary clinical documentation to ensure approval.
Do I need proof of medical necessity for ABA therapy to be covered?
Yes. Insurance companies require documentation showing that ABA therapy is medically necessary for your child’s development. This is usually demonstrated through the diagnostic report and a treatment plan written by a BCBA outlining specific, measurable goals.
How long does it take for insurance to approve ABA therapy?
Approval times vary by insurer, but typically range from 1–3 weeks after all documents are submitted. Delays can occur if additional information is requested. Our team stays in close contact with your insurance to help move the process along.
Are parent/caregiver training sessions covered by insurance?
Yes, most plans include coverage for caregiver training as part of the ABA treatment program. These sessions are considered essential because progress is greatest when parents and caregivers are part of the learning process.
Does insurance cover virtual ABA therapy?
Many insurers do cover telehealth ABA sessions, especially for parent training or supervision by a BCBA. Coverage may depend on your state and specific plan. We can confirm eligibility during your benefits check.
What if my insurance doesn’t cover ABA therapy?
If your plan excludes ABA or limits coverage, we’ll walk you through alternatives—such as appealing the denial, switching to a plan with autism benefits, or exploring private pay or grant options. Some states also offer Medicaid or autism mandates that ensure ABA coverage.
Start ABA Therapy, Covered by Insurance
