ABA therapy with Cigna

Who is eligible

Cigna covers ABA when your child:

• is covered by a Cigna plan that includes behavioral health benefits,
• has a confirmed autism spectrum disorder (ASD) diagnosis, and
• needs ABA for medical reasons, as shown by a BCBA’s assessment.

Cigna treats ABA as not medically necessary for conditions other than autism, and it does not cover other intensive behavioral programs or services that are mainly educational or vocational.

State law can add protections. North Carolina requires plans it regulates to cover autism treatment, including adaptive behavior treatment, and South Carolina requires state-regulated group plans to cover autism treatment for children diagnosed by age eight, until age 16.

How to start ABA therapy with Cigna

1. Benefit check. Send us your child’s Cigna member ID. We confirm ABA coverage, cost sharing, and the authorization steps for your plan.
2. Diagnosis records. We collect the diagnosis report, including the diagnosing professional’s credentials and the date of diagnosis.
3. Assessment. Our BCBA completes a standardized assessment of your child’s social communication and behavior, and collects baseline data in the settings where therapy will happen.
4. Treatment plan. The BCBA writes measurable goals for your child, goals for caregiver training, and a plan for fading services over time.
5. Authorization and first session. We send the request to Cigna. Therapy starts once it is approved.

Once services start

For each new authorization period, the BCBA sends current progress data, collected within 60 days of the request, along with updated goals.

Cigna’s policy expects caregiver training with its own measurable goals, so parents learn to carry strategies into home and community life. The plan also sets clear discharge criteria from the start, so you know what success looks like.