ABA Therapy Insurance Coverage with CareSource

We Handle the Insurance, So You Can Focus on Your Child

If your family is covered by CareSource, we’re here to make the process as easy as possible. ‍

We work directly with CareSource to handle all the paperwork, verify your coverage, and get your child into therapy quickly—so you can focus on your child’s progress and not on the insurance details.

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What’s Covered Under CareSource for ABA Therapy

Here’s what you can expect when using CareSource for ABA therapy. Coverage generally includes:

Comprehensive Behavioral Assessments
‍We confirm your benefits before therapy starts, so you’ll know exactly what’s covered and what to expect.

In-Home ABA Therapy
‍One-on-one therapy in the comfort of your home where your child feels most at ease. This is where ABA therapy happens most effectively, addressing communication, behavior, and life skills.

School-Based Support
‍Therapy that extends into your child’s school environment, ensuring the skills they learn at home carry over into the classroom and social settings.

Parent Training & Support
‍We equip you with the knowledge and skills to continue reinforcing therapy at home, ensuring your child’s progress is consistent and long-lasting.

Ongoing Monitoring & Adjustments
‍Regular tracking of your child’s progress with ongoing adjustments to the therapy plan to ensure continuous improvement.

CareSource’s ABA Therapy Coverage: Key Insights

Eligibility and Coverage

CareSource covers ABA therapy for children under 21 diagnosed with ASD, as part of the Early & Periodic Screening, Diagnostic & Treatment (EPSDT) benefit.

Pre-authorization and Diagnosis

To access ABA services, children must have a formal ASD diagnosis and meet medical necessity criteria. Pre-authorization is also required.

Coverage for Therapy Sessions

CareSource covers a variety of ABA services, including in-home and school-based therapy. The number of therapy hours may vary based on the child’s needs.

Provider Requirements

Services must be provided by a CareSource-enrolled provider, who is qualified to deliver ABA/ABS services.

How Milestone Achievements Works with Your CareSource Plan

At Milestone Achievements, we simplify the process with CareSource. Here’s how we do it:

Reach Out to Us
Provide us with your CareSource plan details and child’s diagnosis, and we’ll start the verification process right away.

We Verify Your Benefits
We’ll contact CareSource to confirm your benefits and check what ABA therapy services are covered, including in-home therapy, school support, and any pre-authorization requirements.

We Handle the Paperwork
Forget about spending time on hold with customer service reps. We’ll take care of all the forms and submissions to CareSource, so you don’t have to.

Therapy Begins
Once your coverage is confirmed, we schedule your child’s first therapy session in your home, on your schedule.

Start the Process Today

Why Families Trust Milestone Achievements with CareSource

Here’s why families working with CareSource choose Milestone Achievements for their child’s ABA therapy:

No Surprises - We confirm your benefits before therapy starts, so you’ll know exactly what’s covered and what to expect.

We Handle the Details - We take care of all the paperwork, authorization, and claims submissions. No stress, no extra work for you.

Therapy in Your Home - ABA therapy that’s personalized to your child’s needs, delivered right where they’re most comfortable—in your home.

Frequently Asked Questions About CareSource Coverage

Who qualifies for ABA/ABS services under CareSource?

Children under age 21 who are CareSource beneficiaries, have a documented diagnosis of ASD, and whose care plan meets established medical‑necessity criteria are eligible.

How many therapy hours does CareSource cover each week?

Coverage depends on individual needs and age. Some children under six may qualify for up to 40 hours per week; older children may receive fewer hours based on their care plan and provider recommendation.

What documentation is needed to get approved for ABA therapy under CareSource?

A formal ASD diagnosis, a treatment plan, and proof of medical necessity are required for ABA therapy approval under CareSource.

Can a family choose any provider for ABA therapy?

The provider must be enrolled in CareSource and credentialed for ABS/ABA services. You can choose from the list of approved providers, but they must be enrolled and credentialed to deliver ABA services.

What if CareSource denies coverage for ABA therapy?

You may appeal the decision, provide additional documentation, and seek supports or advocacy to ensure your child receives appropriate services.

Are there any out‑of‑pocket costs for ABA therapy with CareSource?

CareSource generally does not charge co‑pays or deductibles for ABA therapy under the EPSDT benefit, but it’s always a good idea to check for specific details in your plan.

How long does approval take for ABA therapy under CareSource?

Processing time varies depending on documentation and provider submission. Ensuring a complete application helps minimize delays.

Let’s Get You Covered

Insurance should never be a barrier to your child’s progress. Milestone Achievements works directly with CareSource to ensure your child gets the therapy they need—without the confusion or delays. Let us handle the insurance details so you can focus on your child’s growth.