Healthy Blue ABA Therapy Coverage in North Carolina
One Less Thing To Deal With
Your child needs support. You need a team that shows up consistently and knows what they’re doing. And you need someone who’ll make sure Healthy Blue doesn’t become another obstacle between your family and real progress.
- Verify benefits before your first appointment
- Submit authorizations and handle follow-ups
- Manage claims, reauthorizations, and appeals
How we work with Healthy Blue
Kennedy ABA manages the insurance process so you don’t spend hours learning billing codes and authorization requirements just to access the care your child needs.
Insurance Management
Our in Network of Insurance Providers in North Carolina
We work with all major insurance providers across North Carolina:
Don’t see yours? We might work with them, too. Just ask
lives through
What Healthy Blue covers for ABA therapy
When insurance approves ABA therapy, here’s what’s usually covered:
In-Home ABA Therapy
Direct one-on-one sessions with a trained RBT in your home. Where your child works on communication during actual conversations, practices behavior regulation during real transitions, and builds skills in the environment where they need them most.
School-Based ABA Support
Therapy during your child’s school day—in their classroom, during lunch, at recess. We help them succeed in the moments that matter: participating in group work, managing frustration when assignments get hard, and navigating social situations with peers.
Telehealth ABA Sessions
Virtual therapy appointments that maintain consistency when in-person isn’t possible. Your family gets flexibility without sacrificing progress.
Parent Training & Coaching
Direct instruction on the same strategies our therapists use. You’ll know how to reinforce appropriate requests during dinner, how to handle escalation at bedtime, how to support your child’s progress between sessions and after therapy ends.
Coverage varies by plan, but we’ll walk you through exactly what yours includes.
What Makes Healthy Blue Different
BlueCross BlueShield Medicaid Plan
- Medicaid managed care plan operated by BCBS
- Serves specific NC counties—your county determines eligibility
- Different authorization process than commercial BCBS plans
Medicaid Coverage for Children Under 21
- No annual dollar cap on ABA therapy coverage
- Services covered through EPSDT (Early and Periodic Screening, Diagnostic, and Treatment) benefit
- Must be deemed medically necessary by physician
No Copays or Deductibles
- Zero out-of-pocket costs for ABA therapy services
- Medicaid benefit covers full cost of authorized services
Authorization Requirements
- Requires autism diagnosis and physician recommendation
- Prior authorization required before starting therapy
- Processing time: 10-14 business days typically
- Reauthorization every 6 months
Reach Out
Assessment
Personalized Plan
Therapy Begins
Progress Tracking
How to get started with Healthy Blue
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Step: 01
Contact Kennedy ABA: Call us or fill out our contact form. We'll need your Healthy Blue member ID and your child's autism diagnosis documentation. -
Step: 02
We contact Healthy Blue: We verify your benefits directly with Healthy Blue. You'll get clear answers about what's covered. -
Step: 03
We submit authorization: We prepare and submit the prior authorization request with all required clinical documentation. Then we follow up with Healthy Blue until they process it. -
Step: 04
Your child starts therapy: Once Healthy Blue approves coverage, we schedule your child's first session, in your home or at school, based on your family's needs and schedule.

Whether your child is nonverbal or struggling with language, ABA helps them express needs, ask questions, and connect with others.

Getting dressed, brushing teeth, following routines—these skills build independence and make life easier for your whole family.

Making friends, sharing, taking turns, reading social cues—ABA teaches the building blocks of meaningful relationships.

When meltdowns happen, ABA gives your child tools to manage big feelings and respond to frustration in healthier ways.

ABA doesn’t just stop challenging behaviors—it teaches replacement skills so your child can communicate what they need without aggression or self-injury.

Following instructions, sitting for tasks, transitioning between activities—these skills prepare your child for success in schools.
Getting the most from your Healthy Blue plan
Before starting:
- Keep your Healthy Blue card accessible (you'll need both sides)
- Have your child's autism diagnosis documentation ready
- Ask us what additional paperwork your specific Healthy Blue plan requires
During therapy:
- We monitor your Healthy Blue authorization periods and benefits utilization
- We submit reauthorization requests to Healthy Blue before current approvals expire
- We update you regularly on coverage status and any Healthy Blue communications
If Healthy Blue coverage is limited:
- We'll appeal denials with strong clinical documentation from our BCBA team
- We'll explore payment arrangements for out-of-pocket costs
- Most families find workable solutions—very few end up unable to access services
Why families with Healthy Blue trust Kennedy ABA
Healthy Blue Coverage FAQs
What will ABA therapy cost with my Healthy Blue plan?
Does my Healthy Blue plan require a pediatrician referral?
What documentation does Healthy Blue need for authorization?
How long before Healthy Blue approves authorization?
How many therapy hours will Healthy Blue authorize?
What happens if Healthy Blue denies coverage?
Can I use Healthy Blue HSA or FSA funds?
If I don't have Healthy Blue, can Kennedy ABA still help?
We work with most major insurance providers in North Carolina. If you have different coverage, we likely work with them. Without insurance, we can discuss self-pay options and payment plans.
Does Healthy Blue cover ABA therapy for non-autism diagnoses?
Will Healthy Blue coverage eventually run out?
Is Kennedy ABA in-network with my Healthy Blue plan?
When does my Healthy Blue authorization expire?
Let’s get You Covered
Our team has navigated every variety of Healthy Blue plan, answered every type of coverage question, and handled every insurance complication imaginable.
This is what we do best, so your child can get the help they need. Fast.