In most cases, yes. Virginia's autism insurance law (HB 2467, effective January 1, 2012) requires state-regulated health plans to cover ABA therapy for autism, provided or supervised by a BCBA licensed by the Virginia Board of Medicine. Anthem operates as Anthem Blue Cross Blue Shield in Virginia and covers ABA therapy when medically necessary, typically with prior authorization. Confirm your specific plan with a Verification of Benefits before starting.
Virginia's autism insurance mandate (HB 2467, enacted 2011, effective January 1, 2012) requires coverage for autism spectrum disorder treatment, including ABA therapy, when the ABA is provided or supervised by a board-certified behavior analyst licensed by the Virginia Board of Medicine, with the diagnosing practitioner independent of the ABA provider. The law has been amended since enactment — HB 2577 (2019) and SB 1031 (2020) both changed its scope, including expanding the mandate to small-group and individual plans. Age limits and any annual benefit cap have changed across these amendments; verify current figures directly with Anthem or the Virginia Bureau of Insurance rather than relying on a fixed number, since sources disagree on the current age range post-2019. Self-funded employer plans governed by federal ERISA are generally exempt from this state mandate. Anthem operates as Anthem Blue Cross Blue Shield in Virginia and covers ABA therapy for autism spectrum disorder when the plan includes the benefit and treatment is medically necessary. Note: Anthem HealthKeepers Plus is a separate Medicaid managed care plan — see the dedicated Medicaid page if that is your plan.
Most Anthem plans in Virginia require prior authorization before ABA services begin:
A formal ASD diagnosis from a licensed psychologist or developmental pediatrician, independent of the ABA provider per Virginia law.
Virginia law requires ABA to be provided or supervised by a BCBA licensed specifically by the Virginia Board of Medicine. Confirm your provider holds this license before starting services.
Anthem typically requires a treatment plan with measurable goals, assessment results, weekly therapy hours, and the BCBA's credentials before authorizing ABA services.
Prior authorization review commonly takes 14–30 business days. Submit as early as possible to avoid delays. Call the member services number on your Anthem card to confirm your plan's specific process.
Families in Northern Virginia — including Arlington, Alexandria, Fairfax, Reston, Herndon, McLean, Tysons, Falls Church, Manassas, and Woodbridge — and in the Richmond metro — including Henrico, Chesterfield, Midlothian, Glen Allen, and Mechanicsville — frequently ask whether Anthem covers ABA in their area. Coverage follows Virginia's statewide HB 2467 rules regardless of which city you are in; what varies is provider availability and network status. Harmony Care Finder's provider network spans both corridors, so one coverage check surfaces in-network Anthem options across whichever area is 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 under Virginia's most recent amendment, prior authorization requirements, whether your provider's BCBA is licensed by the Virginia Board of Medicine, deductible, copay, and out-of-pocket maximum.
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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.