INSURANCE & COVERAGE
Insurance & Florida Medicaid for ABA therapy
Insurance shouldn't be the reason your child waits. Here's every plan we accept, what each usually needs before ABA can start, and how we help with the paperwork.
Plans we accept
TRICARE East
Cigna
Molina Healthcare
Sunshine Health (MMA / Medicaid)
Aetna
Blue Cross Blue Shield
Curative
Have a different plan? Call us — we'll check, and if we can't help, we'll tell you who might.
Does Florida Medicaid cover ABA therapy?
Yes. Florida Medicaid covers medically necessary behavior analysis (ABA) for children and young people under 21 through the Statewide Medicaid Managed Care (SMMC) program. Blaze ABA accepts Florida Medicaid through Sunshine Health (MMA) and Molina Healthcare (including the Children's Medical Services plan).
Before services begin, Florida requires a Comprehensive Diagnostic Evaluation (CDE) and prior authorization from your plan. We help you gather the CDE and paperwork, submit the authorization request, and keep you posted until it's approved. (Adults 21 and older access behavior services through the iBudget waiver, a different program.)
Commercial plans: Aetna, Blue Cross Blue Shield, Cigna and Curative
Most major Florida plans cover ABA when it's medically necessary. You'll typically need an autism diagnosis, and your plan may require a referral or prior authorization, or have a deductible or copay. We verify your specific benefits before services start, so you know what your plan requires.
TRICARE East for military families
TRICARE covers ABA for eligible beneficiaries, and its requirements include a referral and specific documentation. We'll walk you through each requirement so nothing holds up your child's start.
What we'll need from you
- Photos of your insurance or Medicaid card (front and back)
- Your child's autism diagnosis or Comprehensive Diagnostic Evaluation (CDE) report
- A physician referral, if your plan requires one
- Your child's IEP or recent school reports, if available (optional)
- Any previous therapy records (optional)
Asking for support at school
School services and ABA through your health plan are separate. If your child needs support in the classroom, you can ask for it in your child's Individualized Education Program (IEP) by sending a written request to the Exceptional Student Education (ESE) contact at your child's school or to your school district's ESE department. If your child doesn't have an IEP yet, you can request an evaluation through the same channels. Describe your concerns about your child's development, learning or behavior as clearly as you can.
Coverage questions
Does ABA through insurance affect my child's school services or IEP?
No. Medical ABA through your health plan and services through your child's IEP are separate. Your child can have both, and with your permission the people involved can share what's working.
What if my authorization is denied?
A denial isn't always the final word. Your plan's letter explains the reason and how to appeal, including deadlines. Call us and we'll talk through the letter and your options with you.
Do I need a diagnosis before I call?
No. Call us anyway. If your child doesn't have a diagnosis yet, we can explain the steps to a Comprehensive Diagnostic Evaluation and point you to UCF CARD's free family support while you wait.
My plan isn't listed. What should I do?
Call (239) 465-8663. We'll check, and if we can't help, we'll tell you who might.
Let's talk about your child.
Tell us a little about your family and we'll walk you through coverage, timing and next steps — no pressure, no jargon.