Insurance Coverage at Achieve ABA
We've Got You Covered
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.
Vaya Health insurance coverage for ABA therapy
Behind every phone call to an insurance company, every appointment scheduled, and every late-night search for answers is a parent who loves their child deeply. If that’s you, we want to begin by saying—you’re doing a wonderful job.
At
Achieve ABA, we help families like yours understand Vaya Health’s coverage for ABA therapy and take the next steps with confidence. We’ll handle the details so you can focus on what matters most: your child.
Does Vaya Health cover ABA therapy?
Yes. Vaya Health provides coverage for ABA therapy for children and adolescents with autism spectrum disorder (ASD) and, in some cases, other developmental or behavioral challenges.
ABA therapy is considered a medically necessary service when recommended by a qualified provider and approved through Vaya’s authorization process.
That means families like yours can access meaningful, evidence-based ABA therapy services without shouldering the entire financial burden.
Who is eligible for ABA therapy under Vaya Health?
Eligibility typically depends on:
✓ A formal diagnosis of autism or related condition
✓ A recommendation for ABA services from a licensed professional
✓ A clinical review process with Vaya Health to confirm medical necessity
We know that sounds technical…
but you don’t have to figure it out alone.
Our team has walked many parents through this process step by step, from diagnosis paperwork to insurance approvals.
What does Vaya Health's ABA coverage include?
While each child’s plan may differ, coverage often includes:
✓ Initial assessments by a Board Certified Behavior Analyst (BCBA)
✓ Individualized ABA treatment plans tailored to your child’s goals
✓ Ongoing therapy sessions delivered one-on-one or in small groups
✓ Parent training and support, so you can feel confident using ABA strategies at home
Because coverage can vary, we always verify your specific benefits and explain any out-of-pocket costs up front—no surprises, just clarity.
How to start ABA therapy with Vaya Health
Getting started may feel overwhelming, but we break it into simple steps:
1. Contact Achieve ABA—we’ll listen to your family’s needs.
2. Verify insurance coverage—we call Vaya Health directly on your behalf.
3. Complete the clinical process—we help with the evaluation and documentation needed.
4. Begin services—your child is matched with a caring ABA team who’s ready to help.
Families often tell us they felt relieved once they had a trusted partner walking with them through the insurance maze. You don’t need to do this alone.
Why choose Achieve ABA with Vaya Health?
Experience with Vaya Health: We know their system and can make the process smoother for you.
Compassionate providers: Our therapists genuinely care about your child’s progress, offering both
in-home ABA therapy and
school-based autism support tailored to real-life needs.
Support for parents: We keep you informed, answer your questions, and celebrate every milestone with you.
ABA therapy is more than insurance codes and paperwork—it’s about giving your child the chance to thrive.
FAQs about Vaya Health ABA therapy coverage
Does Vaya Health cover ABA therapy for autism?
Yes. Vaya Health, through NC Medicaid and its Tailored Plan, covers ABA therapy under a benefit called Research-Based Behavioral Health Treatment (RB-BHT). If your child has an autism diagnosis and is under 21, ABA is considered a covered service when it’s medically necessary.
What if my child doesn’t have a full autism diagnosis yet?
For children under 3, a provisional diagnosis can often be enough to begin ABA therapy. Full evaluation and documentation will still be required later, but you don’t have to wait to start getting help.
Do I need prior authorization before starting ABA therapy?
Yes. Vaya Health requires prior authorization for ABA services. That means the treatment plan must be reviewed and approved before therapy begins, and then renewed periodically. Achieve ABA takes care of this process for you.
How many ABA hours will Vaya Health approve?
There isn’t a standard number of hours for every child. Vaya reviews each treatment plan individually and authorizes the number of hours based on medical necessity and clinical recommendations.
Does Vaya Health cover parent or caregiver training?
Yes. Parent and caregiver involvement is considered an essential part of ABA therapy and is included in coverage. These sessions give you tools and strategies to support your child outside of therapy.
Is ABA therapy through Vaya Health only available in person?
Most services are provided in person, but some components—such as parent training or certain clinical meetings—may be approved for telehealth. This depends on your child’s plan and what is most appropriate.
Finding support with Vaya Health and Achieve ABA
If you’ve found yourself here, it means you’re already taking steps for your child’s future. That matters. Insurance rules and authorizations may feel like obstacles, but they don’t have to stand in your way.
At Achieve ABA, we walk families through every stage—from understanding Vaya Health coverage to celebrating your child’s progress in therapy.
