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What Is The Age Limit For ABA Therapy In North Carolina?

Find out what the age limit is for receiving Applied Behavior Analysis (ABA) therapy in North Carolina.

steven zauderer
Steven Zauderer
September 15, 2023
min read

What Is The Age Limit For ABA Therapy In North Carolina?

In North Carolina, the age limit for ABA therapy is 19 years old. But why is this so?

Throughout the US, health insurance companies are by and large required to cover ABA therapy for the children of parents. This can be done through private insurance or Medicaid. ABA coverage for most insurers is limited to adults and children at sometimes differing ages in every state.

While one state might place the cap at 21, another could be younger. And in the case of North Carolinians, that age is 19 years. The ABA cutoff sometimes coincides with the limit that health providers are willing to pay.

ABA is considered to be an essential treatment for people with autism and is mandated to be covered by the US government. The majority of people receiving ABA therapy are children, though some adolescents also attend. Children most often attend in part from the disorder being diagnosed at an early age. The earlier that treatment is started, the better symptoms can become manageable by someone's diagnosis.

Anyone wishing to receive coverage after 19 will in most cases be better off going to a private insurer. It's with a private insurer that Medicare may cover some of the spaces in their treatment, with ABA possibly being one of them.

What Is The Age Range For ABA Therapy In North Carolina?

The typical age range for ABA therapy in North Carolina is 18 months to 19 years old.

This is the usual range of age for which children receive the most coverage, either through Medicaid or a private health insurer. Again, the age range reflects that at which most insurance companies in the state will offer help to parents and the child attending ABA.

Since autism spectrum disorder is detected at a young age, treatment can start years before school begins.

Early treatment paves the way for autistic children to adapt to their environment, learn social cues, and even reduce the severity of symptoms. The treatment can include numerous plans, like help in understanding language, better eating habits, and help with any learning issues a child might face.

Parents can easily find monetary help for children needing treatment, including full coverage in some circumstances. On top of what private insurance companies must pay for, further coverage could be attained through grants, Medicaid, insurance policies offered by treatment centers, and even the insurance of the companies that parents are employed to.

How Long Do Kids Stay In ABA In North Carolina?

In North Carolina, ABA therapy can last from weeks to months and years. On average, most children, adolescents, and adults getting treatment do so for a period of two to three years. If more treatment is required, another two to three years could give a total of four to six years spent in ABA therapy.

Longer treatments are usually reserved for level three autism, which is the diagnosis showing the most intense and recurring symptoms. It can start before school, during, or even after completing high school for some.

Longer treatment does cost more, and parents will continue to have their children covered in the state until early adulthood. The cap for mandatory coverage for most patients is $40,000 in the state. Without insurance,

ABA can cost anywhere from $60,000 to $200,000 annually. Because of the expensive costs, therapists and parents sometimes aim to get the most out of treatment as early and swiftly as possible.

Still, this isn't possible with all children, particularly those with symptoms that prevent them from living out an ordinary childhood.

steven zauderer

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

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