In most cases, yes. New Jersey's autism insurance law (P.L. 2009, c.256) requires state-regulated health plans to cover ABA therapy for autism with no dollar cap and no age limit. Anthem Blue Cross Blue Shield covers ABA therapy when medically necessary. Confirm your specific plan with a Verification of Benefits before starting.
New Jersey's autism insurance mandate (P.L. 2009, c.256) requires state-regulated health insurance policies to cover the diagnosis and treatment of autism spectrum disorder, including ABA therapy. New Jersey's law is notable for having no annual dollar cap and no age limit on ABA coverage — among the strongest state mandates in the country. Self-funded employer plans governed by federal ERISA are generally exempt from this state mandate. Anthem operates as Anthem Blue Cross Blue Shield in New Jersey and covers ABA therapy for autism spectrum disorder when the plan includes the benefit and treatment is medically necessary.
Most Anthem plans in New Jersey 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 northern New Jersey — including Bergen, Essex, Hudson, Morris, Passaic, and Union counties — and in central New Jersey — including Middlesex, Monmouth, Ocean, and Somerset counties — frequently ask whether Anthem covers ABA in their area. Coverage follows New Jersey's statewide P.L. 2009, c.256 rules regardless of which county you are in; what varies is provider availability and network status. Harmony Care Finder's provider network spans the state, 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, prior authorization requirements, deductible, copay, and out-of-pocket maximum. Ask specifically whether your employer plan is fully-insured (covered by NJ's mandate) or self-funded.
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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.