Insurance Coverage at Achieve ABA

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Every child deserves the opportunity to thrive - and that includes having access to the therapy they need. Navigating insurance coverage can feel overwhelming, but we're here to make the process a breeze.

Healthy Blue insurance coverage for ABA therapy

Every parent wants the best for their child, but navigating insurance can sometimes feel like a barrier. With Healthy Blue insurance coverage for ABA therapy, families in North Carolina can breathe a little easier knowing that support is available. 


From assessments to individualized therapy and caregiver training, Healthy Blue may provide the services your child needs to learn, grow, and succeed. At Achieve ABA, we’ll make the process clear, compassionate, and simple.

Understanding Healthy Blue ABA therapy coverage

Healthy Blue is the name for Medicaid plans offered by Blue Cross and Blue Shield of North Carolina for families approved for NC Medicaid coverage.



In North Carolina, state law requires ABA therapy (referred to as Adaptive Behavioral Treatment or ABT) to be covered for eligible children up to age 19, subject to medical necessity and benefit limits. Families may receive up to $40,000 per year in benefits, but services do require medical documentation and prior authorization before therapy can begin.

Coverage through Healthy Blue often includes:

✓ Initial evaluations and ABA assessments

✔ Individualized treatment plans by a BCBA

✔ One-on-one ABA therapy sessions

✔ Regular progress reviews and adjustments

✔ Parent and caregiver training

How to begin ABA therapy with Healthy Blue

Starting ABA therapy under Healthy Blue autism therapy coverage feels more manageable with the right support. Here’s how the journey typically unfolds:

1. Your child receives an official ASD diagnosis from a licensed professional.

2. We complete an ABA assessment and develop a treatment plan.

3. We submit documentation—including diagnosis, evaluation, and justification—to Healthy Blue for authorization.

4. Once approved, ABA therapy with Achieve ABA can begin.

Why families turn to Achieve ABA

Families choose Achieve ABA because they want a partner—not another form to fill out. With Healthy Blue ABA therapy coverage, you’ll have someone to:

Verify and explain your benefits in plain language

Coordinate authorizations and handle follow-ups with Healthy Blue

Connect you with qualified, in-network providers

Deliver compassionate in-home ABA therapy and school-based autism support, tailored to your child’s strengths

FAQs about Healthy Blue ABA therapy coverage

  • Does Healthy Blue cover ABA therapy?

    Yes. Healthy Blue Medicaid in North Carolina covers ABA therapy (also called Adaptive Behavioral Treatment) for children with an autism spectrum diagnosis. Coverage includes assessments, therapy sessions, treatment planning, and caregiver training.

  • What ages are eligible for Healthy Blue ABA coverage?

    ABA therapy through Healthy Blue autism therapy coverage is available for children up to age 19, as long as services are considered medically necessary and authorized.

  • What services are included with Healthy Blue ABA therapy?

    Families may receive benefits for autism evaluations, individualized ABA sessions, treatment planning by a BCBA, ongoing progress reviews, and caregiver training to support learning at home.

  • Does Healthy Blue require prior authorization for ABA therapy?

    Yes. Healthy Blue insurance coverage for ABA therapy requires prior authorization and medical documentation before services can begin. Achieve ABA will manage this process on your behalf.

  • Is there a limit to Healthy Blue ABA therapy coverage?

    Yes. In North Carolina, Healthy Blue ABA therapy coverage typically has an annual cap of $40,000 per year for eligible children. Achieve ABA will confirm your exact plan details and explain what’s included.

Your next step with Healthy Blue and ABA therapy

Insurance shouldn’t feel like a barrier. With Healthy Blue insurance coverage for ABA therapy, Achieve ABA will handle the details so your family can focus on what matters most—your child’s progress.