Anthem is one of the largest health benefits companies in the United States, serving over 45 million members. As a Blue Cross Blue Shield licensee in many states, Anthem provides comprehensive autism and ABA therapy coverage with a strong network of behavioral health providers.
Verify Your Anthem Coverage →Anthem covers ABA therapy as part of its behavioral health benefits. Coverage includes functional behavior assessments, treatment planning, intensive behavioral intervention, and caregiver training. Anthem typically approves 20-40 hours per week based on the child's treatment plan and medical necessity.
$20-$50 per session
Per session (varies by plan)
Required
We help with the auth process
PPO, HMO, EPO plans
Plan options available
Anthem covers ABA therapy as part of its behavioral health benefits. Coverage includes functional behavior assessments, treatment planning, intensive behavioral intervention, and caregiver training. Anthem typically approves 20-40 hours per week based on the child's treatment plan and medical necessity.
The typical copay for ABA therapy with Anthem is $20-$50 per session. Actual costs depend on your specific plan, deductible status, and whether you use in-network providers. Many families pay little to nothing out-of-pocket for ABA services.
Yes, Anthem typically requires prior authorization for ABA therapy services. This means your provider needs to submit a treatment plan and get approval before starting services. Harmony Care Finder helps families navigate this process and connects you with providers experienced in Anthem authorizations.
Harmony Care Finder verifies insurance acceptance before matching you with providers. Simply tell us your Anthem plan details, and we'll connect you with verified providers in your area who accept your specific plan. Our service is free for families.
Coverage hours depend on medical necessity as determined by the treating BCBA's assessment. Most Anthem plans cover 20-40 hours per week of ABA therapy when clinically recommended. Hours are typically reviewed every 6 months during reauthorization.
Learn about ABA therapy coverage from other major insurance providers:
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