ABA therapy and Molina Healthcare

What is covered

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

Molina focuses on Medicaid and marketplace plans. If your Molina plan is a Medicaid plan, the EPSDT rules for children under 21 apply.

Ask them: Is my Molina plan a Medicaid plan or a marketplace plan?

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.