ABA therapy and Humana

What is covered

Humana generally covers ABA for an autism diagnosis when it is medically necessary and prior authorized. Your plan document decides the specifics.

Humana sells commercial, Medicare Advantage and, in some states, Medicaid plans. For a child's ABA the relevant plan is almost always the commercial or Medicaid one.

Ask them: Which Humana plan covers my child, and does it require prior authorization for ABA?

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.