MEDCOST 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 MEDCOST doesn’t become another obstacle between your family and real progress.

What Kennedy ABA does with your MEDCOST plan:

How we work with MEDCOST

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.

Here’s What We Do:

We verify first

Give us your MEDCOST information, and we'll confirm exactly what's covered before you commit to treatment. No mid-therapy surprises about what MEDCOST will or won't pay for.

We submit authorization requests

MEDCOST won't approve ABA therapy without prior authorization. We know exactly what documentation they need, how they want it formatted, and who to follow up with when they go silent.

We break down your costs

Before your child's first therapy session, you'll know what MEDCOST pays and what comes out of your pocket. Real numbers based on your actual plan—not ballpark estimates that turn into billing problems later.

We handle the administrative chaos

Submitting claims to MEDCOST, following up when on the paperwork, resubmitting when they request more information, appealing when they deny coverage they should approve—we manage it all.

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

We tackle challenges and transform
lives through

What MEDCOST 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 MEDCOST Different

Regional Provider Network

State Mandate Compliance

Typical Requirements

Authorization Timeline

How it works

How Kennedy ABA Works in

Reach Out

Contact us to learn about ABA therapy. We'll answer your questions, verify your insurance, and explain what to expect. No pressure, just honest conversation.

Assessment

A Board Certified Behavior Analyst (BCBA) meets with your family to assess your child's needs, strengths, and challenges. This informs everything we do next.

Personalized Plan

Your BCBA creates a treatment plan tailored specifically to your child's goals. Every plan is different because every child is different.

Therapy Begins

Our Registered Behavior Technicians (RBTs) provide one-on-one therapy in the setting that works best for your family—whether that's your home, your child's school, or in the community.

Progress Tracking

We measure progress with data—not guesses. You'll see exactly what's improving, what needs adjustment, and how far your child has come.

How to get started with MEDCOST

Step: 01
Contact Kennedy ABA: Call us or fill out our contact form. We'll need your MEDCOST member ID and your child's autism diagnosis documentation.
Step: 02
We contact MEDCOST: We verify your benefits directly with MEDCOST. 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 MEDCOST until they process it.
Step: 04
Your child starts therapy: Once MEDCOST approves coverage, we schedule your child's first session, in your home or at school, based on your family's needs and schedule.

What ABA Therapy Helps Kids Learn

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 MEDCOST plan

Before starting:

During therapy:

If MEDCOST coverage is limited:

About Us

Why families with MEDCOST trust Kennedy ABA

We've processed hundreds of MEDCOST authorizations. We understand their documentation requirements, typical processing timelines, and how to appeal when they issue questionable denials.

We know how MEDCOST works.

You don't need to become fluent in insurance terminology and medical billing codes. We handle everything MEDCOST-related from initial verification through final claims.

We manage the entire process.

We verify your MEDCOST benefits before therapy begins. You get clear cost information—not vague estimates that turn into surprise billing statements months later.

You know the costs upfront.

In your home during real routines and transitions. At school, during actual lessons and peer interactions. Not in a clinic practicing skills that don't transfer to the environments where your child actually needs them.

Therapy happens where it matters

When MEDCOST denies coverage, we explain the actual reason—which often differs from their official denial letter—and appeal with documentation that addresses their real concerns.

We're direct

FAQ

MEDCOST Coverage FAQs

What will ABA therapy cost with my MEDCOST plan?

Depends entirely on your specific plan details. Some MEDCOST families pay only their monthly premium with no additional costs. Others have copays ($10-50 per session typically), deductibles, or coinsurance percentages. We verify your exact financial responsibility before your child’s first session.

Does my MEDCOST plan require a pediatrician referral?

Some MEDCOST plans do, others don’t. We’ll check your specific plan requirements and help you obtain any necessary referrals.

What documentation does MEDCOST need for authorization?

Typically, an official autism diagnosis, a comprehensive treatment plan from our BCBA, and completed prior authorization forms. Sometimes MEDCOST requests additional records from your child’s physician or educational team. We handle all submissions and follow-up communications.

How long before MEDCOST approves authorization?

Usually 7-14 business days. Sometimes faster when MEDCOST has everything they need immediately. Occasionally, longer if they request supplementary documentation or flag the case for additional review. We push for expedited approvals and keep you informed throughout.

How many therapy hours will MEDCOST authorize?

Most MEDCOST plans in North Carolina approve 10-40 weekly hours, depending on clinical necessity and plan limitations. We request what your BCBA determines your child needs. If MEDCOST approves fewer hours, we appeal with clinical justification.

What happens if MEDCOST denies coverage?

We help you appeal using additional clinical documentation from our BCBA team and your child’s medical providers. Most MEDCOST denials get overturned when you provide the right supporting information.

Can I use MEDCOST HSA or FSA funds?

Yes. ABA therapy qualifies as a medical expense, so MEDCOST HSA or FSA accounts can cover copays, deductibles, and any out-of-pocket costs.

If I don't have MEDCOST, 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 MEDCOST cover ABA therapy for non-autism diagnoses?

Some MEDCOST plans extend ABA coverage to ADHD or other developmental conditions. Many don’t. We’ll verify what your specific MEDCOST plan covers.

Will MEDCOST coverage eventually run out?

MEDCOST typically covers ABA therapy as long as it remains medically necessary. We monitor your benefits throughout treatment and keep you informed about coverage status.

Is Kennedy ABA in-network with my MEDCOST plan?

We work with MEDCOST throughout North Carolina. During benefits verification, we’ll confirm whether we’re in-network with your specific plan—which typically means lower costs for your family.

When does my MEDCOST authorization expire?

MEDCOST usually authorizes ABA therapy in 3-6 month periods. We track expiration dates and submit renewal requests 30 days early to prevent service interruptions while MEDCOST processes new authorizations.

Still Have Questions?

Let’s get You Covered

Our team has navigated every variety of MEDCOST 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.