ABA therapy and Carelon Behavioral Health

What is covered

Carelon Behavioral Health manages the behavioral health benefit on behalf of other insurers, so it may not be the name on your card. Whether ABA is covered is set by your plan; Carelon Behavioral Health is usually who reviews and authorizes it.

Carelon Behavioral Health administers behavioral benefits for other carriers. It was previously known as Beacon Health Options, so older paperwork may still use that name.

Ask them: Is my behavioral benefit carved out to Carelon, formerly Beacon?

Self-funded or fully insured?

Ask your employer which yours is. Fully insured plans follow your state's autism mandate; self-funded plans follow federal rules instead. Many cover ABA either way.

Before your first session

• Confirm the agency is in network, not just willing to bill.
• Ask how many authorized hours, over what dates.
• Ask your copay per session.
• Get the reauthorization date in writing.