ABA therapy and Optum

What is covered

Optum 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; Optum is usually who reviews and authorizes it.

Optum is not usually the name on the insurance card. It administers the behavioral health benefit for UnitedHealthcare and for a number of employer plans, which means the ABA authorization is handled by Optum even when the card says something else.

Ask them: Is Optum administering my behavioral benefit, and what is their authorization process?

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.