UnitedHealthcare 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 UnitedHealthcare 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 UnitedHealthcare
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 UnitedHealthcare 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 UnitedHealthcare Different
Two Different Plans
- UnitedHealthcare Commercial: Follows NC state mandate ($40,000 cap, children under 18)
- UnitedHealthcare Community Plan: Medicaid managed care with different structure
Optum Manages ABA Network
- UnitedHealthcare uses Optum to manage ABA therapy authorization and network
- Authorization requests go through Optum, not directly through UnitedHealthcare
- Adds coordination step that can extend timelines
Prior Authorization Required
- Comprehensive assessment required before authorization
- Treatment plan must include specific, measurable goals
- Typically approves conservative hours initially (10-20 per week)
Commercial Plan Details
- $40,000 annual cap for children under 18
- Prior authorization timeline: 10-14 business days
- Reauthorization every 3-6 months
Community Plan (Medicaid) Details
- No annual cap for children under 21
- Zero copays or deductibles
- Authorization through Optum: 10-21 business days
Reach Out
Assessment
Personalized Plan
Therapy Begins
Progress Tracking
How to get started with UnitedHealthcare
-
Step: 01
Contact Kennedy ABA: Call us or fill out our contact form. We'll need your UnitedHealthcare member ID and your child's autism diagnosis documentation. -
Step: 02
We contact UnitedHealthcare: We verify your benefits directly with UnitedHealthcare. 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 UnitedHealthcare until they process it. -
Step: 04
Your child starts therapy: Once UnitedHealthcare 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 UnitedHealthcare plan
Before starting:
- Keep your UnitedHealthcare card accessible (you'll need both sides)
- Have your child's autism diagnosis documentation ready
- Ask us what additional paperwork your specific UnitedHealthcare plan requires
During therapy:
- We monitor your UnitedHealthcare authorization periods and benefits utilization
- We submit reauthorization requests to UnitedHealthcare before current approvals expire
- We update you regularly on coverage status and any UnitedHealthcare communications
If UnitedHealthcare 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 UnitedHealthcare trust Kennedy ABA
UnitedHealthcare Coverage FAQs
What will ABA therapy cost with my UnitedHealthcare plan?
Does my UnitedHealthcare plan require a pediatrician referral?
What documentation does UnitedHealthcare need for authorization?
How long before UnitedHealthcare approves authorization?
How many therapy hours will UnitedHealthcare authorize?
What happens if UnitedHealthcare denies coverage?
Can I use UnitedHealthcare HSA or FSA funds?
If I don't have UnitedHealthcare, 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 UnitedHealthcare cover ABA therapy for non-autism diagnoses?
Will UnitedHealthcare coverage eventually run out?
Is Kennedy ABA in-network with my UnitedHealthcare plan?
When does my UnitedHealthcare authorization expire?
Let’s get You Covered
Our team has navigated every variety of UnitedHealthcare 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.