Insurance & Funding

Navigating insurance for ABA therapy can feel overwhelming — but you don’t have to do it alone.

At Pivotal Achievements, our team helps families understand their coverage and explore every possible option to access high-quality ABA services for their child.

Autism Diagnosis Requirement

Most health plans require an official autism diagnosis in order to cover ABA therapy. Coverage is based on each plan’s eligibility rules and benefits criteria. Before starting services, our team verifies benefits and eligibility as a courtesy, so you know exactly what’s covered and what costs, if any, may apply.

In-Network Plans

We are in-network with select insurance providers. If your plan is in-network, our team will handle authorizations and guide you through the process to begin therapy as smoothly as possible.

Out-of-Network Coverage

Not in-network? You may still have coverage! Many families use out-of-network benefits to access ABA therapy. Our team will:

Verify your child’s out-of-network benefits.
Walk you through what is covered and what your financial responsibility may be.
Submit claims directly to your insurance when possible, so you don’t have to manage extra paperwork.

Marketplace & Employer Plans

If your current insurance doesn’t cover ABA, or if Medicaid changes have made it difficult to continue, you still have options:

Marketplace Plans: Some Marketplace plans include autism/ABA therapy benefits.
Employer Plans: If a parent has coverage through work, adding your child to the employer’s plan may provide ABA benefits.

Why Families Choose Us

We know that every family’s situation is different. Our commitment is to help you understand your options clearly, avoid surprises, and focus on what matters most — your child’s progress.

REQUEST ABA THERAPY