What Families Should Know About Funding ABA Therapy

Insurance Coverage for ABA Therapy

Private Health Insurance

Under the Affordable Care Act (ACA), many states require private insurers to cover ABA therapy for autism. This means that employer-provided or individual health plans often include coverage for ABA services. The specifics of coverage—such as the amount of authorized hours, age limits, and approved providers—can vary by plan.

In states with autism insurance reform laws, ABA therapy is generally defined as a covered benefit. Families should check their Explanation of Benefits (EOB) or contact their insurance provider to understand:

• Whether ABA is covered
• Annual or lifetime maximums
• Required provider credentials
• Prior authorization procedures

Medicaid and CHIP

For eligible children, Medicaid and the Children’s Health Insurance Program (CHIP) often cover ABA therapy. Coverage may differ by state, but generally includes medically necessary behavioral health services when prescribed by a qualified provider. Many families qualify based on income and disability status.

Some states have “waiver” programs that allow Medicaid to cover additional services, including intensive ABA therapy. Examples include Home and Community-Based Services (HCBS) waivers that support therapies beyond what standard Medicaid covers.

Public School Services

Under the Individuals with Disabilities Education Act (IDEA), public schools must provide special education supports for eligible students. While schools do not always provide clinic-style ABA therapy, many IEP teams include behavior-based supports such as:

• Behavior intervention plans (BIPs)
• In-school therapy hours
• Social skills instruction
• Communication goals

These services are free under IDEA and can supplement outpatient ABA therapy.

Sliding Scales and Reduced Fee Programs

Some ABA clinics offer a sliding scale based on family income, adjusting the cost of services to make therapy more accessible. In addition, community mental health centers or university-affiliated programs may provide ABA services at reduced rates or as part of research studies.

Families can inquire whether a provider offers:

• Sliding fee scales
• Payment plans
• Pro bono or sponsored slots

Not all clinics provide these options, but it can be a helpful alternative when insurance or public programs are limited.

Grants and Financial Assistance

Nonprofit and Autism Support Organizations

Several nonprofits offer grants or scholarships to help families afford therapy, equipment, or respite care. Organizations such as the Autism Science Foundation, local autism societies, and national autism support networks sometimes provide financial awards for therapy expenses.

Each grant program has its own eligibility requirements and application timeline, so families should check early and often for available opportunities.

Employer Benefits

Some employers offer Flexible Spending Accounts (FSAs) or Health Savings Accounts (HSAs) that allow pre-tax dollars to be used for approved therapy expenses, including ABA. Families should consult their HR representative to understand which expenses qualify.

Tax Credits and Deductions

Families who pay for ABA therapy may qualify for tax deductions or credits. For example:

• Medical expense deductions if total medical costs exceed a certain percentage of adjusted gross income
• Dependent care credits in some cases

Tax rules change frequently, so consulting a tax professional or IRS resources can help families understand potential savings.



Care Coordination and Advocacy

Knowing how to navigate funding options is often as important as the therapy itself. Many families work with a case manager, care coordinator, or autism support organization to understand:

• Insurance appeals for denied ABA coverage
• Medicaid waivers and eligibility
• School IEP advocacy for behavioral services

Getting professional guidance can help families maximize available resources.



Conclusion

Affording ABA therapy can feel overwhelming, but many families are able to access care through insurance coverage, Medicaid programs, school-based services, grants, and financial planning tools. Understanding these options can help families make informed decisions and reduce financial barriers to consistent, effective support.

At Inclusive ABA, we help families navigate both care and coverage. Serving communities across Nevada, Nebraska, Colorado, Utah, Iowa, and Ohio, our team works closely with families to verify benefits, explain funding options, and deliver high-quality ABA therapy tailored to each child’s needs. Our goal is to make support more accessible, transparent, and family-focused every step of the way.



FAQs

Sources:

• https://www.autismspeaks.org/applied-behavior-analysis
• https://www.autism.org.uk/advice-and-guidance/what-is-autism
• https://www.healthcare.gov/glossary/affordable-care-act/
• https://www.healthcare.gov/medicaid-chip/childrens-health-insurance-program/
• https://www.medicaid.gov/medicaid/home-community-based-services
• http://www.ed.gov/laws-and-policy/individuals-disabilities/idea
• https://www.understood.org/en/articles/what-is-an-iep
• https://childmind.org/article/what-is-a-behavior-intervention-plan/
• https://www.americanbar.org/groups/delivery_legal_services/initiatives_awards/alternative_fees/