In most cases, yes. Illinois requires state-regulated health plans to cover ABA therapy for autism spectrum disorder. Anthem Blue Cross Blue Shield covers ABA therapy when medically necessary. Confirm your specific plan with a Verification of Benefits before starting.
Illinois requires state-regulated health insurance plans to cover the diagnosis and treatment of autism spectrum disorder, including ABA therapy. The mandate applies to fully-insured group and individual plans issued in Illinois. Self-funded employer plans governed by federal ERISA are generally exempt from this state mandate. Anthem operates as Anthem Blue Cross Blue Shield in Illinois and covers ABA therapy for autism spectrum disorder when the plan includes the benefit and treatment is medically necessary. Confirm current age limits and benefit caps directly with Anthem, as Illinois law has been amended over time.
Most Anthem plans in Illinois require prior authorization before ABA services begin:
A formal ASD diagnosis from a licensed psychologist or developmental pediatrician is required before submitting a treatment plan.
Anthem typically requires a treatment plan with measurable goals, assessment results, weekly therapy hours, and the BCBA's credentials before authorizing ABA services.
Authorizations are typically reviewed every 6–12 months. Call the member services number on your Anthem card to confirm your plan's specific authorization process.
Families across the Chicago metro — including Cook, DuPage, Kane, Lake, McHenry, and Will counties — and in downstate Illinois cities such as Springfield, Peoria, and Rockford frequently ask whether Anthem covers ABA in their area. Coverage follows Illinois's statewide mandate regardless of which area you are in; what varies is provider availability and network status. Harmony Care Finder's provider network spans the Chicago metro and downstate Illinois, so one coverage check surfaces in-network Anthem options closest to you.
Call the member services number on your Anthem card and request a Verification of Benefits. Confirm: ABA coverage, current age and benefit limits, prior authorization requirements, deductible, copay, and out-of-pocket maximum.
Use Our Free Coverage Check →Let us check your benefits and match you with Illinois providers who accept Anthem. It's free.
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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.