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Insurance & Coverage for ABA Therapy

Q: My plan isn’t listed. Can you still help?

Contact us and we’ll tell you what your options are. We also offer private pay and out-of-network options.

Insurance can feel confusing, and you don’t have to figure it out alone. Here are the plans we accept, how ABA coverage usually works, and what to expect along the way.

Ask About Coverage Call 970-999-5720

Insurance We Accept

Aetna
UMR
Health First Colorado (Colorado’s Medicaid program)
Cigna
Blue Cross Blue Shield
Optum

Coverage depends on your specific plan. We check your benefits for you before the assessment, so you know where you stand.

Prefer not to use insurance, or have a plan that isn’t listed? We also offer private pay and out-of-network options.

How ABA Coverage Usually Works

Check your benefits. The first step is finding out what your plan covers for ABA: whether it’s covered for your child, whether Attain is in network, and what you may pay. At Attain, we check your benefits for you before the assessment.
Gather your paperwork. Many plans ask for a diagnosis and, sometimes, a referral or prescription from your child’s doctor before they approve ABA. Medicaid may require additional documentation from your doctor.
Assessment. A Board Certified Behavior Analyst (BCBA) assesses your child and writes a treatment plan with recommended goals and hours. Some plans require approval for the assessment itself.
Prior authorization. The treatment plan is sent to your plan, which reviews it for medical necessity and decides how many hours it will cover. Approvals last for a set period, then the BCBA submits an updated plan to continue.
Ongoing care and bills. As therapy continues, you may receive Explanation of Benefits statements from your plan. Your share depends on your deductible, copay or coinsurance, and out-of-pocket maximum.

Questions to ask your plan

Is ABA therapy covered for my child’s diagnosis?
Is Attain SLB in network for my plan?
Do I need a referral, or a diagnosis from a specific type of provider?
Is prior authorization required for the assessment, for therapy, or both?
What are my deductible, copay or coinsurance, and out-of-pocket maximum?
Is there a limit on hours or visits?
Is in-home ABA covered the same way as clinic-based ABA?

Colorado’s Autism Coverage Law, in Plain English

Colorado law requires state-regulated health plans to cover the assessment, diagnosis, and treatment of autism spectrum disorder when treatment is medically necessary (Section 10-16-104 (1.4), C.R.S.). The Colorado Division of Insurance says commercial plans must meet minimum coverage requirements for autism treatment, including applied behavior analysis (ABA).

There’s an important catch. State mandates apply to fully insured plans regulated by the Division of Insurance. Self-funded employer plans, union plans, federal employee plans, government plans such as Medicaid or Medicare, and plans issued in other states are not subject to Colorado’s mandates. Covered services can also still come with deductibles, coinsurance, or other cost sharing.

Not sure which kind of plan you have? If your insurance comes through work, ask your HR or benefits team: “Is our health plan fully insured or self-funded?” Our parent guide Does insurance cover ABA therapy in Colorado? goes into more detail.

Plan-by-Plan Notes

These notes are general. Your own plan documents and member services line have the final word.

Aetna

We accept Aetna. Aetna asks ABA providers to submit a treatment request for precertification, so expect an approval step before therapy begins. If your Aetna plan comes through an employer, ask HR whether it is fully insured or self-funded, because that affects which rules apply.

Ask Aetna: Is ABA covered for my child, is precertification required for the assessment and for treatment, and what will my cost share be?

UMR

We accept UMR. UMR is a third-party administrator hired by employers to run their health plans, and it is a UnitedHealthcare company. That usually means your employer, not UMR, decides what the plan covers. Your plan documents (often called the Summary Plan Description) spell out ABA benefits.

Ask your HR team or UMR: Does our plan cover ABA, what approval is needed, and are there hour or visit limits?

Health First Colorado (Colorado’s Medicaid program)

We accept Health First Colorado. For members age 20 and under, ABA falls under the Pediatric Behavioral Therapies benefit. Here is how the state describes the process:

The provider assesses your child, puts together a treatment plan, and submits a Prior Authorization Request (PAR).
Licensed clinical reviewers check the request for medical necessity. You and your provider receive a letter with the decision.
If approved, the approval says how many hours may be provided. Each approved PAR is valid for up to six months, and a new PAR is needed to continue.
If a PAR is denied, your provider can ask for a reconsideration, and you can file a written appeal within 30 calendar days.

Medicaid may also require additional documentation from your doctor.

Cigna

We accept Cigna. If your Cigna coverage comes through work, it may be fully insured or self-funded by your employer, so the details depend on your specific plan. Your member services number, on the back of your card, can confirm ABA benefits and approval requirements.

Ask Cigna: Is ABA covered for my child’s diagnosis, is prior authorization required, and is in-home ABA covered the same way as clinic-based ABA?

Blue Cross Blue Shield

We’re in network with Blue Cross Blue Shield in Colorado. BCBS plans are offered by independent local companies, so benefits vary by plan and by state. Out-of-state BCBS plans: call us and we’ll check your coverage.

Ask your BCBS plan: Is Attain SLB in network for me, is ABA covered, and what approval is needed?

Optum

We accept Optum. If your insurance card lists Optum or United Behavioral Health for behavioral or mental health, that’s usually the team that manages ABA benefits and approvals for your plan.

Ask Optum: Is ABA covered for my child, what prior authorization is required, and how often does it need to be renewed?

Common Insurance Questions

Will insurance pay for all of my child’s ABA?+

We can’t promise that, because it depends on your plan. Many plans still have a deductible, copay, or coinsurance for covered ABA, and approvals can limit hours. The best way to know is to check your benefits, and we do that for you before the assessment.

Do I need prior authorization?+

Usually, yes. Health First Colorado requires a prior authorization request before behavioral therapies start, and commercial plans commonly require approval too. Your plan can tell you exactly what it requires.

What if my plan denies or reduces the hours requested?+

Denials can often be reconsidered or appealed. Health First Colorado, for example, offers a reconsideration and a written appeal, which must reach the Office of Administrative Courts within 30 calendar days of the denial notice. Your plan’s denial letter explains your options and deadlines.

My plan isn’t listed. Can you still help?+

Ask About Coverage

Sources

This page is general information, not a guarantee of coverage or cost. Last reviewed October 2026.

Not Sure Whether Attain Is the Right Fit Yet?

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970-999-5720|Monday to Friday, 8am to 6pm|1224 E Elizabeth St, Fort Collins, CO 80524

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