ABA coverage by plan
Medicaid Every state, plus waiver programsUnitedHealthcare Commercial, behavioral via OptumAetna Commercial, marketplace and MedicaidCigna Commercial, behavioral via EvernorthBlue Cross Blue Shield Independent plan in each stateTricare Autism Care DemonstrationAnthem Blue plan across several statesKaiser Permanente Integrated, care within KaiserHumana Commercial and Medicaid in some statesOptum Behavioral administrator, not the cardMagellan Behavioral carve-out administratorCarelon Behavioral Health Formerly Beacon Health OptionsMolina Healthcare Medicaid and marketplaceAmbetter Marketplace plans from CentenePrivate pay No insurance, or out of network
Self-funded or fully insured?
Ask your employer which one your plan is. Fully insured plans follow your state's autism mandate. Self-funded plans follow federal ERISA rules instead, and many still cover ABA. The answer decides which rules apply if you have to appeal a denial.