Insurance & Coverage

We accept Medicaid for people with a diagnosis of autism. Medicaid covers ABA therapy as well as psychological evaluations for autism.

Autism diagnosis at Affinity is available only to individuals 18 and under who have Medicaid. In most cases, an autism diagnosis is required before insurance will cover treatment.

After you apply, our team gathers your personal and insurance information and calls your insurance plan’s benefits and eligibility line. We document:

• Your specific plan, its effective date, and whether it runs on a calendar year or a plan year
• Your benefits for ABA therapy at one of our locations and at home
• Individual and family deductibles and out-of-pocket maximums, and how much of each has been met
• Whether ABA needs an authorization, and the steps to start one
• Any limits your plan places on ABA

The call can take anywhere from 15 minutes to a couple of hours, depending on the insurer’s wait time and whether the phone number on your insurance card is the right one for benefits.

We then email you a walk-through of your benefits and an estimate of your monthly cost, and often follow up with a phone call. From there, timing depends on when you are ready with any questions and whether you would like to schedule a meet and greet. If the cost is high, we can set up a payment plan that spreads it across the year.