Aetna ABA Therapy Coverage in North Carolina

Aetna & ABA Therapy in North Carolina

Aetna is one of the largest national health insurers and offers coverage for Applied Behavior Analysis (ABA) therapy across most of its plan types. If you have an Aetna plan in North Carolina, your child’s ABA therapy is likely covered under behavioral health benefits.

Coverage Details

Aetna generally covers ABA therapy as a medically necessary treatment for Autism Spectrum Disorder. Most Aetna plans in North Carolina include:

• Diagnostic assessments — Comprehensive evaluations and Functional Behavior Assessments
• Individual ABA therapy — One-on-one sessions with a Registered Behavior Technician
• BCBA supervision — Regular oversight and treatment plan updates by a Board Certified Behavior Analyst
• Parent training — Caregiver coaching to reinforce skills at home
• Telehealth services — Remote supervision and parent training sessions

Coverage specifics depend on your individual plan, including whether you have an employer-sponsored, marketplace, or individual plan.

Prior Authorization

Aetna requires prior authorization for ABA therapy services. This involves submitting clinical documentation, including a diagnosis of ASD and a treatment plan developed by a BCBA. Our team manages the entire authorization process on your behalf, from initial submission through renewals.

Verification

Contact us and we’ll verify your Aetna benefits within 48 hours. We confirm your plan’s specific coverage details, including session limits, copays, and in-network status, so there are no surprises before services begin.