In most cases, yes. New York requires health plans to cover ABA therapy for autism spectrum disorder. Aetna covers ABA therapy when medically necessary, usually with prior authorization. Confirm your specific plan with a Verification of Benefits before starting.
New York's autism insurance mandate requires health insurance plans to cover the diagnosis and treatment of autism spectrum disorder, including ABA therapy. New York Insurance Law sections 3221(l)(5) and 4303(cc) require coverage for ASD treatment in individual and group policies. The mandate applies to fully-insured plans issued or renewed in New York. Self-funded employer plans governed by federal ERISA are generally exempt from state mandates, though many cover ABA voluntarily. Aetna covers ABA therapy for autism spectrum disorder when the plan includes the benefit and treatment is medically necessary. Note: Aetna operates in New York through several plan types — confirm whether your specific plan is subject to New York's mandate by calling the member services number on your card.
Most Aetna plans require prior authorization before ABA services begin in New York:
A formal autism spectrum disorder diagnosis from a licensed psychologist, developmental pediatrician, or neurologist is required.
Aetna typically requires a comprehensive treatment plan with measurable goals, assessment results, weekly therapy hours, and the BCBA's credentials.
The process commonly takes 14-30 business days. Aetna applies its standard medical-necessity review process.
New York's largest ABA therapy markets include New York City (all five boroughs), Long Island (Nassau and Suffolk counties), Westchester County, the Hudson Valley, and the Buffalo/Rochester/Syracuse corridor upstate. Harmony Care Finder can match you with Aetna-accepting ABA providers across all of these regions.
Call the member services number on your Aetna card and request a Verification of Benefits. Confirm: ABA coverage, prior authorization requirements, deductible, copay, out-of-pocket maximum.
Use Our Free Coverage Check →Let us check your benefits and match you with New York providers who accept Aetna. It's free.
Check My Coverage →This page is pending review by a named BCBA or BCBA-D. A working BACB Certificant Registry link will be added once a reviewer is confirmed.
This content is for informational purposes only and does not constitute medical, clinical, or therapeutic advice. Consult a licensed healthcare provider or Board Certified Behavior Analyst (BCBA) before making therapy decisions for your child.
Data current as of August 2026. Coverage terms and provider availability change frequently — verify directly with your insurance carrier and the provider before scheduling.