Insurance & Medi-Cal for ABA Therapy

How we help with coverage

Insurance can feel like the hardest part of getting started. You don’t have to figure it out alone. When you call us, we can:

• Walk you through what your plan typically requires for ABA therapy
• Explain the documents you may need, such as a diagnosis report or referral
• Help start the authorization process
• Talk through any expected out-of-pocket costs before services begin

Medi-Cal and ABA therapy

In California, Medi-Cal covers Behavioral Health Treatment (BHT), which includes Applied Behavior Analysis, for members under 21 when services are medically necessary. Only a physician or psychologist can determine that BHT is medically necessary. Members enrolled in a Medi-Cal managed care plan receive BHT through their health plan (California Department of Health Care Services). In Orange County, many Medi-Cal members are enrolled with CalOptima Health.

For a step-by-step explanation, read Does Medi-Cal cover ABA therapy?

Private and employer insurance

Many commercial health plans also cover ABA therapy for autism, but benefits, requirements and costs differ from plan to plan. The quickest way to find out is to call the member services number on your insurance card, or call us and we’ll help you check.

Plans we work with

We work with Medi-Cal and a range of health plans. Because networks change, please call (714) 709-7819 to confirm whether we can work with your specific plan.

What to have ready when you call

• Your child’s insurance card (you can share details by phone — please don’t send ID numbers through our website form)
• Any diagnosis report or recommendation you already have
• Your child’s pediatrician’s name
• Questions or concerns you’d like to discuss

This page is general information, not insurance or legal advice. Coverage depends on your specific plan. Always confirm benefits with your health plan.