Magellan ABA therapy coverage in Colorado

We handle the Magellan paperwork. You docus on your child.

Magellan covers ABA therapy for children with autism in Colorado—and Achieve Behavioral manages the entire insurance process from start to finish.

Authorization. Claims. Reauthorization. We take care of it so you don't have to.

How Magellan covers ABA therapy in Colorado

Colorado autism insurance law requires coverage

Colorado law mandates that health insurance plans, including Magellan, cover ABA therapy for children with autism spectrum disorder. This means your Magellan plan is required to provide benefits for medically necessary ABA services.

What Magellan typically covers

✔ BCBA assessments and treatment planning

✔ Direct ABA therapy sessions (in-home, school-based, community-based)

✔ Parent training and caregiver support

✔ Ongoing BCBA supervision and treatment adjustments

Understanding Magellan

Magellan Health is a behavioral health management company that administers behavioral health benefits for various insurance carriers and employer groups. If your insurance card says "Magellan Healthcare" or "Magellan Behavioral Health," your behavioral health benefits are managed by Magellan, even if your medical benefits are through a different carrier.

Magellan manages behavioral health services including:

✔ Mental health therapy

✔ Substance use treatment

✔ ABA therapy for autism

✔ Psychiatric services

✔ Care coordination

Magellan plan types in Colorado

Magellan manages behavioral health benefits for various insurance carriers and employer groups in Colorado, including:

✔ Employer-sponsored health plans

✔ State and municipal employee plans

✔ Federal employee plans

✔ Commercial insurance carriers

✔ Medicaid managed care plans (Health First Colorado)

The Magellan authorization process (we handle this)

Step 1: We verify your benefits

Within 48 hours of receiving your intake paperwork, we contact Magellan to verify your coverage, check your deductible, and confirm any out-of-pocket costs.

Step 2: We submit the prior authorization request

ABA therapy requires prior authorization from Magellan. We submit all necessary documentation—including the autism diagnosis, BCBA assessment, and treatment plan—directly to Magellan's clinical review team.

Step 3: Magellan reviews and approves

Magellan typically reviews authorization requests within 10-14 business days. We follow up with Magellan's clinical reviewers throughout the process and keep you updated on the status.

Step 4: Therapy begins

Once Magellan approves the authorization, we match your child with a qualified therapist and begin services. You don't lift a finger.

Step 5: We handle reauthorization

Magellan authorizations are typically approved for 3-6 months at a time. Before your authorization expires, we submit a reauthorization request with updated progress data. You never experience a gap in services.

What families pay with Magellan

Understanding your out-of-pocket costs

Your out-of-pocket costs depend on your specific health plan and how Magellan administers your behavioral health benefits.

Most families pay:

✔ Deductible (if not yet met)

✔ Copay per session (typically $10-$50)

✔ Coinsurance (typically 10-20% of the session cost)

Once you hit your plan's out-of-pocket maximum, Magellan covers 100% of ABA therapy costs for the rest of the calendar year.

Medicaid (Health First Colorado) families

If you have Magellan through Medicaid (Health First Colorado), ABA therapy is covered with no copays, deductibles, or out-of-pocket costs.

We tell you what to expect upfront

During the verification process, we'll tell you exactly what your financial responsibility will be—before therapy starts. No surprises.

Why Achieve makes Magellan coverage easy

We verify benefits within 48 hours

You submit your intake paperwork. We contact Magellan and verify your coverage within two business days. You know what to expect before therapy begins.

We handle all authorizations and reauthorizations

You never have to call Magellan. We submit authorization requests, follow up with Magellan's clinical review team, and manage reauthorizations before your current approval expires.

We submit all claims directly to Magellan

After each therapy session, we bill Magellan directly. You receive an Explanation of Benefits (EOB) in the mail showing what Magellan paid and what (if anything) you owe.

We navigate Magellan's system for you

Magellan's behavioral health system can be complex—separate authorization portals, clinical reviewers, care coordinators, and specific documentation requirements. We know how Magellan works and handle all of it.

We keep you informed

If Magellan requests additional documentation, denies coverage, or requires an appeal—we handle it and keep you updated every step of the way.

Helpful Optum resources

Magellan Member Portal

Log in to check your behavioral health benefits, view claims, and access resources.

Find a Magellan Provider

Search for in-network behavioral health providers (Achieve is already in-network).

Magellan Customer Service

Contact Magellan with questions about your behavioral health benefits. Member Services: 1-800-424-3175

Magellan Provider Resources

Information for healthcare providers working with Magellan (for reference).

Health First Colorado (Medicaid)

Information for families with Magellan through Colorado Medicaid.

Colorado Division of Insurance

File a complaint or learn about your rights as a Colorado insurance consumer.

Common questions about Magellan ABA therapy coverage

  • Does Magellan cover ABA therapy in Colorado?

    Yes. Colorado law requires health plans to cover medically necessary ABA therapy for children with autism. Magellan manages these benefits on behalf of various insurance carriers and employer groups.

  • What's the difference between Magellan and my medical insurance?

    Magellan is a behavioral health management company. Your medical benefits may be through a different insurance carrier (like Blue Cross Blue Shield, UnitedHealthcare, etc.), but your behavioral health benefits are administered by Magellan.

  • Do I need a referral from my pediatrician?

    It depends on your specific health plan. Some plans managed by Magellan require a referral; others do not. We'll verify this during the benefits check.

  • How long does Magellan authorization take?

    Magellan typically reviews prior authorization requests within 10-14 business days.

  • How many ABA therapy hours does Magellan cover?

    The number of authorized hours depends on your child's clinical need as determined by the BCBA assessment. Magellan does not have a predetermined hour cap—coverage is based on medical necessity.

  • What if Magellan denies coverage?

    If Magellan denies an authorization request, we file an appeal on your behalf with supporting clinical documentation. Denials are rare when the request is properly documented.

  • Does Magellan cover parent training?

    Yes. Parent training is a required component of ABA therapy and is covered under your Magellan-managed benefits.

  • Can I use Magellan for ABA therapy at home and at school?

    Yes. Magellan covers ABA therapy in multiple settings—home, school, daycare, and community—as long as the services are medically necessary.

  • What happens when my authorization expires?

    We submit reauthorization requests before your current authorization expires, so there's no gap in services.

  • Who do I call with questions about my benefits?

    Call Magellan's member services line at 1-800-424-3175. The number is also on the back of your insurance card. We're also here to help navigate any questions you have.

Colorado locations we serve with Magellan coverage

✔ Denver

✔ Aurora

✔ Lakewood

✔ Arvada

✔ Westminster

✔ Thornton

✔ Centennial

✔ Littleton

✔ Parker

✔ Castle Rock

✔ Highlands Ranch

✔ Lone Tree

✔ Englewood

✔ Greenwood Village

✔ Cherry Hills Village

✔ Broomfield

✔ Northglenn

✔ Commerce City

✔ Brighton

✔ Wheat Ridge

✔ Golden

✔ Superior

✔ Louisville

✔ Lafayette

✔ Longmont

✔ Boulder

Achieve Behavioral handles the entire Magellan insurance process - from verification to authorization to billing - so you can focus on what matters: your child's progress.