Optum ABA therapy coverage in Colorado

We handle the Optum paperwork. You focus on your child.

Optum 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 Optum covers ABA therapy in Colorado

Colorado autism insurance law requires coverage

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

What Optum typically offers

✔ 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 Optum

Optum is a behavioral health division of UnitedHealthcare. If your insurance card says "Optum" or "United Behavioral Health," your behavioral health benefits are managed by Optum, even if your medical benefits are through UnitedHealthcare. Optum manages behavioral health services including:

✔ Mental health therapy

✔ Substance use treatment

✔ ABA therapy for autism

✔ Psychiatric services

Optum plan types in Colorado

Optum manages behavioral health benefits for various UnitedHealthcare plans, including:

✔ UnitedHealthcare PPO plans

✔ UnitedHealthcare HMO plans

✔ UnitedHealthcare POS (Point of Service) plans

✔ UnitedHealthcare Choice Plus

✔ UnitedHealthcare Medicaid (Health First Colorado)

The Optum authorization process (we handle this)

Step 1: We verify your benefits

Within 48 hours of receiving your intake paperwork, we contact Optum 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 Optum. We submit all necessary documentation—including the autism diagnosis, BCBA assessment, and treatment plan—directly to Optum's behavioral health division.

Step 3: Optum reviews and approves

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

Step 4: Therapy begins

Once Optum 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

Optum 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 Optum

Understanding your out-of-pocket costs

Your out-of-pocket costs depend on your specific UnitedHealthcare/Optum plan.

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, Optum covers 100% of ABA therapy costs for the rest of the calendar year.

Medicaid (Health First Colorado) families

If you have UnitedHealthcare 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 Optum coverage easy

We verify benefits within 48 hours

You submit your intake paperwork. We contact Optum 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 Optum. We submit authorization requests, follow up with Optum's clinical review team, and manage reauthorizations before your current approval expires.

We submit all claims directly to Optum

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

We navigate Optum's system for you

Optum's behavioral health system can be confusing—separate portals, different phone numbers, clinical reviewers who need specific documentation. We know how Optum works and handle all of it.

We keep you informed

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

Helpful Optum resources

Optum Member Portal

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

UnitedHealthcare Member Portal

Log in to check your medical benefits and overall plan details.

Find an Optum Provider

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

Optum Customer Service

Contact Optum with questions about your behavioral health benefits. Behavioral Health Customer Service: 1-877-236-2224

UnitedHealthcare Customer Service

Contact UnitedHealthcare with questions about your medical benefits. Customer Service: 1-800-328-5979

Health First Colorado (Medicaid)

Information for families with UnitedHealthcare through Colorado Medicaid.

Colorado Division of Insurance

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

Common questions about Optum ABA therapy coverage

  • Does Optum cover ABA therapy in Colorado?

    Yes. Colorado law requires Optum to cover medically necessary ABA therapy for children with autism. Medicaid plans through UnitedHealthcare/Optum also cover ABA therapy.

  • What's the difference between Optum and UnitedHealthcare?

    Optum is the behavioral health division of UnitedHealthcare. Your medical benefits are handled by UnitedHealthcare, but your behavioral health benefits (including ABA therapy) are managed by Optum.

  • Do I need a referral from my pediatrician?

    It depends on your specific UnitedHealthcare plan type. HMO plans typically require a referral; PPO and POS plans often do not. We'll verify this during the benefits check.

  • How long does Optum authorization take?

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

  • How many ABA therapy hours does Optum cover?

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

  • What if Optum denies coverage?

    If Optum 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 Optum cover parent training?

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

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

    Yes. Optum 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.

  • Why does my insurance card say UnitedHealthcare but you mention Optum?

    Optum manages behavioral health services for UnitedHealthcare plans. Your card may say UnitedHealthcare, but ABA therapy authorizations and claims go through Optum's behavioral health division.

Colorado locations we serve with Optum 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 Optum insurance process—from verification to authorization to billing—so you can focus on what matters: your child's progress.