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Is ABA Therapy Covered By Insurance In Arizona?

Find out if Applied Behavior Analysis is covered by insurance in Arizona.

steven zauderer
Steven Zauderer
September 15, 2023
min read

Is ABA Therapy Covered By Insurance In Arizona?

Yes, most health insurance companies are required to include ABA therapy in Arizona as a part of their coverage for people with autism spectrum disorder.

Almost all health insurance providers cannot deny coverage to anyone residing in the state. They're by law required to assist in the price for ABA treatment, though there is no law requiring them to cover any alternative treatments for autism, such as individual speech therapy.

There are many ABA therapy companies in Arizona, including Cross River Therapy, Action Behavior Centers, Golden Steps ABA, Total Care ABA, The Treetop ABA, BehaviorCareTherapy, AutismTherapies, and AZUnited.

In Arizona, people are eligible for benefits and subject to coverage for anything that's considered to be essential for people with autism to need, with ABA therapy being the primary. It's based upon a $50,000 cap in benefits annually for children in infancy and up to the age of nine. For kids between the ages of nine and 16, the coverage cap is $25,000 each year.

Arizona law mandates that certain health insurance companies give coverage for an autism diagnosis and its treatment, which is predicated on the needs of every individual.

Today, Arizona law covers initial diagnosis and behavioral therapy services. Any services that deviate from what's typically given for autism treatment, may or may not be covered. Still, that doesn't necessarily mean that insurance companies would outright deny treatment for parents seeking more than ABA therapy for the treatment of their child.

Is ABA Therapy Covered By Medicaid In Arizona?

ABA therapy is covered by Medicaid in the state of Arizona.

Medicaid is federally regulated health insurance for children, typically those with a limited income. However, there are stipulations with Medicaid that make coverage for ABA therapy available to all, which is the case for Arizona residents.

This means that the parents of a child with autism can be covered with medicare, regardless of how high or low their income is. Although many children can receive treatment through Medicaid, not every ABA center in the state is authorized to accept it. If the coverage is medically necessary, however, most treatment centers will take the health insurance provider that is by law mandated to cover ABA treatment. How much Medicaid covers could be subject to the age and needs of the child receiving treatment.

Will Insurance Cover ABA For ADHD In Arizona?

Health insurance companies aren't mandated to cover ABA treatment for ADHD individuals in the state of Arizona.

ABA treatment is sometimes sought after for children with ADHD since many of the disorder's symptoms are parallel to those found in autism. However, this isn't authorized to be covered by insurance agencies, or even Medicaid. Parents are strongly recommended to contact their insurance provider to see if coverage is possible in some form. Of course, this doesn't guarantee success.

Many ABA centers will treat children with the disorder and accept many health insurance companies. The best method for an ADHD child to receive treatment is through a psychologist, physician, or pediatrician's recommendation to an insurance provider. This has produced desirable results for children and parents. Parents might also have ABA covered for their ADHD kids through employee insurance.

Insurance Providers That Cover Applied Behavior Analysis In Arizona

  • Aetna - Covers behavioral health costs that are certified with an official diagnosis.
  • Kaiser Permanente - Cover individual costs for ABA.
  • Arizona Health Care Cost Containment System, or AHCCCS) - Arizona's Medicaid program for children.
  • Cigna Healthcare of Arizona - Cover individual ABA costs.
  • Ambetter - Coverage may extend testing as well as treatment costs.

This list of insurance providers isn't exhaustive, but many private insurers will also cover ABA with either a $25,000 or $50,000 limitation.

steven zauderer

CEO of CrossRiverTherapy - a national ABA therapy company based in the USA.

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