Insurance and costs
Insurance shouldn't stand between your child and support.
Insurance questions? We'll help you sort it out. We help you understand your coverage and handle the paperwork with you, so you know what to expect before sessions begin.
[Confirm: benefit checks, authorization support, and appeals handled by NorthStar]
Prefer to talk? Call [PHONE] and we'll walk through your plan with you.
Accepted plans
Insurance plans we accept
Coverage varies by plan. If you don't see yours, call us anyway. We'll help you check. [Confirm accepted plans and add logos]
- [Plan name]
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- [Medicaid managed care plan]
- [Medicaid managed care plan]
- [Plan name]
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Unsure about your coverage?
You don't have to figure it out alone. Our team is here to help.
The basics
Does insurance cover ABA therapy?
Many health plans cover ABA therapy. What changes from plan to plan is the detail: how many hours are approved, what you pay, and what paperwork comes first.
We'll go over your specific plan with you, in plain words, before your child starts.
[Billing lead to confirm New York coverage details, including state-regulated plans, self-funded employer plans, and Medicaid]
Usually needed before coverage begins
- A diagnosis from a licensed provider, such as a psychologist, developmental pediatrician, or neurologist.
- A referral or prescription for ABA therapy.
- Prior authorization from your plan, based on an assessment by a BCBA.
Don't have these yet? That's okay. Call us and we'll talk through next steps together, privately, by phone.
[Clinical and billing leads to confirm this list]
What to expect
Getting covered, step by step
From your first call to your child's first session, here's how it usually goes. [Add typical timeframes after confirmation]
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Reach out
Fill out the short form, chat with us, or call. We'll ask about your plan on the phone, never in a web form.
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We check your benefits
We look at what your plan covers and what you'd pay, then explain it in plain words. [Confirm]
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Assessment and authorization
A BCBA gets to know your child and builds a plan. It's sent to your insurance for approval. [Confirm who submits and follows up]
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Sessions begin
Once approved, sessions start at home or at school, with regular check-ins along the way.
Costs
What will ABA therapy cost?
It depends on your plan. What you pay may include a copay, coinsurance, or deductible.
We'll help you understand your costs before your child starts, so there are no surprises. [Confirm whether families get a written estimate]
- With insurance: your plan's copay, coinsurance, or deductible. [Confirm]
- Medicaid: [Confirm Medicaid plans and what families typically pay]
- Self-pay: [Self-pay rates and options, if offered]
Don't see your plan?
Ask us anyway. It's one phone call.
Plan names and networks change, and this page can't list every policy. Leave your details and we'll call to check your coverage with you.
[Confirm out-of-network or single case agreement options, if any]
For your privacy, please don't enter insurance member numbers or medical details online. We'll go over your plan by phone.
Check my coverage
We'll call you to go over your plan.
Questions
Insurance questions families ask
Which insurance plans do you accept?
[List accepted plans] Coverage varies by plan, so call us and we'll check yours.
Do you accept Medicaid?
[Confirm Medicaid and Medicaid managed care plans accepted]
Does my child need a diagnosis before insurance will cover ABA?
Most plans require a diagnosis from a licensed provider and a referral for ABA before they'll cover it. If you don't have these yet, call us and we'll talk through next steps. [Confirm]
What is prior authorization?
It's your plan's approval to begin therapy, usually based on an assessment by a BCBA and the treatment plan they write. [Confirm how NorthStar handles it]
How long does approval take?
It depends on your plan and on scheduling your child's assessment. We'll keep you updated along the way. [Add typical timeframe after confirmation]
What if my insurance says no?
[Confirm what NorthStar does if a request is denied, such as appeals support]
Will I be involved once sessions start?
Yes. Families are partners, with regular updates and coaching.
Questions about coverage? We're here.
One call is all it takes to start. We'll walk you through your plan and what comes next.