Yes, in most cases. Anthem HealthKeepers Plus, one of Virginia's Medicaid managed care plans, covers ABA therapy as a medically necessary treatment for children with autism.
Verify Your Coverage →What This Tells You
Anthem HealthKeepers Plus is a Medicaid managed care plan, not the same product as Anthem's commercial insurance. If your family is enrolled in Virginia Medicaid and assigned to this plan, ABA coverage runs through Medicaid's EPSDT entitlement, not through Anthem's commercial policies.
Anthem HealthKeepers Plus is one of the managed care organizations (MCOs) contracted to administer Virginia Medicaid. It's one of the largest Medicaid MCOs operating in the state, covering children and youth including those in foster care and former foster care.
Because this is a Medicaid managed care plan, coverage runs through the federal EPSDT (Early and Periodic Screening, Diagnostic, and Treatment) benefit, which entitles Medicaid-enrolled children under 21 to medically necessary care.
In practice, expect to need:
As of January 1, 2026, a federal rule (CMS-0057-F) requires Medicaid managed care plans to decide standard prior authorization requests within 7 calendar days, and urgent requests within 72 hours.
Confirm the provider is in-network specifically for Anthem HealthKeepers Plus, not just for "Anthem" broadly — commercial and Medicaid MCO networks are not always identical.
Check your coverage to confirm your plan details, and use our Virginia provider directory to find ABA providers near you.
No. Anthem HealthKeepers Plus is a Virginia Medicaid managed care plan. Anthem's commercial plans are a separate product line with their own coverage rules and provider networks.
In most states, Medicaid allows enrollees to request a plan change, particularly when network adequacy is a documented problem. Contact Virginia's Medicaid managed care enrollment help line.
Yes. A documented autism spectrum disorder diagnosis from a licensed evaluator is required before ABA can be authorized as medically necessary.
Let us check your benefits and match you with providers who accept your plan. It's free.
Check My Coverage →This content is for informational purposes only and does not constitute medical, clinical, or therapeutic advice.
Data current as of July 2026.