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About Anthem ABA Coverage
Anthem is one of the largest health benefits companies in the United States, serving over 45 million members. As a Blue Cross Blue Shield licensee in many states, Anthem provides comprehensive autism and ABA therapy coverage with a strong network of behavioral health providers.
What's Covered
Anthem covers ABA therapy as part of its behavioral health benefits. Coverage includes functional behavior assessments, treatment planning, intensive behavioral intervention, and caregiver training. Anthem typically approves 20-40 hours per week based on the child's treatment plan and medical necessity.
Coverage Details
PPO, HMO, EPO plans
Required for ABA services
$20-$50 per session
IN, VA, GA, CO, MO
How to Get Started
- Verify your benefits - Call the number on your insurance card or use our free benefits check tool
- Get a diagnosis - If your child doesn't have an autism diagnosis, we can connect you with diagnostic providers
- Find a provider - Browse our verified Anthem-accepting providers in your area
- Request authorization - Your provider will submit a pre-authorization request to Anthem
- Start therapy - Once approved, begin ABA therapy services
Frequently Asked Questions
Yes, Anthem covers ABA therapy for individuals diagnosed with Autism Spectrum Disorder. Coverage is typically provided as part of behavioral health benefits, though specific coverage details vary by plan. Most Anthem plans cover 20-40 hours per week of ABA therapy based on medical necessity.
With Anthem, typical out-of-pocket costs range from $20-$50 per session depending on your specific plan. Many families pay little to nothing after meeting their deductible. We recommend calling the number on your insurance card to verify your specific benefits.
Yes, Anthem requires pre-authorization for ABA therapy services. Your ABA provider will typically handle this process for you, submitting the necessary documentation to Anthem for approval before starting services.
Use our provider search tool to find Harmony-verified ABA providers who accept Anthem. All providers in our network have been vetted for quality and credentials. You can also callAnthem directly or use their online provider directory.
Ready to Check Your Anthem Benefits?
Our team can help you understand your Anthem coverage and connect you with verified ABA providers in your area.
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