Can insurance deny ABA therapy?

Insurance can deny ABA therapy, but a denial is often not the final answer. Common reasons include a missing or unaccepted diagnosis, a plan that doesn’t include autism benefits, missing paperwork, or a decision that the hours requested aren’t medically necessary.

Ask for the denial in writing with the exact reason. Then file an internal appeal with your plan, with a letter from your BCBA or doctor explaining why the therapy is needed. If the plan is state-regulated and still says no, the Utah Insurance Department explains how to request an independent review. Self-funded employer plans follow federal rules instead, through the U.S. Department of Labor. Your provider can usually help assemble the records an appeal needs.