ABA Therapy

If you have a child with autism spectrum disorder, you may have heard of ABA therapy and how effective it is at helping autistic children work through behavioral issues. But will Medicaid in NJ cover your child’s ABA therapy treatments?

Let’s examine the issue.


What Is Medicaid?

Medicaid is a healthcare plan that can help partially, or fully, cover certain medical expenses. The program is subsidized by the federal government; however, it is provided by each state. The specific rules, qualification standards, and coverages change slightly by state. 

In New Jersey, this health insurance can be used by pregnant women, parents, caretakers of dependent children, blind individuals, the elderly, and the disabled. It can pay for many health services, including hospital stays, doctors, medications, and even home care.

To qualify you’ll need to be an American citizen and meet specific financial benchmarks that prove your need for government assistance.

What Is ABA Therapy?

ABA, or applied behavior analysis, is a kind of behavioral therapy. It teaches autistic children functional skills, like how to complete simple tasks. It can also encourage positive behaviors and can help your autistic child become better at interacting with others. These are big goals, but they are met by breaking them down into smaller pieces that are easier to understand and master.

How Does ABA Therapy Work?

This therapy can help an autistic child with a wide range of skills. First, your ABA therapy provider or therapist will work with you and the child to pinpoint where your child needs the most help. After that, an ABA plan can be made for them. 

What this plan may include?

This plan can help your child work through language and communication issues. Through reinforcement methods, you can also help promote positive behaviors in your child, while the negative behaviors become less prevalent. 

ABA therapy can also help your child learn how to do simple tasks, like getting dressed and ready in the morning, which are often difficult for autistic children.

Overall, with these new skills and confidence, your child will be better equipped for social interactions, they will know how to complete basic life skills and have the know-how to acquire new skills independently.

You’ll make a schedule with your therapist that fits into your lifestyle. They’ll work with you to ensure the therapy takes place in an environment that your child is comfortable in. This can include at school, daycare, or even at home. Once therapy begins, the real work starts and you’ll be there to support your child through the processes!

How Much Does ABA Therapy Cost in New Jersey?

This will depend on where you live and what therapist you turn to. Typically, though, a single hour of ABA therapy will cost around $120. The costs will quickly add up with multiple sessions, and this estimate does not cover initial appointment and analysis costs.

Don’t forgo this vital therapy because your family is under financial strain. After all, it can help your child live a more fulfilling, self-reliant, and successful life. Finding alternative ways to cover the cost if you don’t have insurance, like through Medicaid, will be a great benefit to your autistic child and your family.

Is ABA Therapy Covered by Medicaid in New Jersey?

For many years, Medicaid did not cover autism therapy treatments like ABA. However, as of April 1, 2020, the state of New Jersey now offers Medicaid assistance for numerous services that can help autistic children.

These services include nearly everything, including physical, occupational, and speech therapies. Along with that, all the assessments that will be done on your child to create an effective ABA therapeutic strategy are also covered by New Jersey Medicaid.

Approximately 40% of autistic children in New Jersey need ABA therapy, and Medicaid makes it more accessible for those who would have difficulty giving their child this help without assistance. Any autistic children who need ABA therapy will get reimbursed for the costs associated with this therapy if they are protected under a Medicaid plan.


How to Get Medicaid Coverage for ABA Therapy in New Jersey

As for any other medical assistance you’d like to seek from the state, you must be enrolled in Medicaid to get these benefits. If you are not already enrolled for Medicaid, reach out to your County Welfare Agency to see if you’re eligible or screen for your own eligibility at NJ Helps

You will also need to have your child taken to a doctor and officially diagnosed with autism spectrum disorder (ASD). Without an ASD diagnosis, you won’t get access to these benefits, even if your child needs them. 

The physician may also recommend a treatment plan for your child or direct you to a specialized person who is better equipped to make a treatment plan. This will hopefully lead you to an ABA therapy service that fits your child’s needs.

After getting your child diagnosed with ASD and finding the right treatment plan, get in touch with different ABA services to see if they accept Medicaid assistance. Once you find the right service provider, treatment can begin and your child can start receiving the benefits of ABA therapy. 

Alertnate ideas to Medicaid coverage of ABA therapy

If Medicaid coverage is not an option for you, New Jersey has several alternatives that may be available. Here are a few options to consider:

  1. Private insurance: Many private insurance plans cover ABA therapy for children with autism. Parents should check with their insurance provider to see if ABA therapy is covered under their plan.
  2. School-based services: Public schools in New Jersey are required to provide special education services to eligible students with disabilities, including autism. ABA therapy may be provided through the school district’s special education program.
  3. Autism non-profit organizations: There are several non-profit organizations in New Jersey that provide support and resources to families affected by autism. Some of these organizations may offer funding or scholarships for ABA therapy.
  4. Grants and fundraising: Families may be able to apply for grants or use fundraising efforts to help cover the cost of ABA therapy. Some organizations may offer grants specifically for families affected by autism.
  5. Sliding fee scales: Some ABA therapy providers may offer sliding fee scales or payment plans based on a family’s income or financial need.

It’s important to note that the availability and coverage of ABA therapy can vary depending on the provider and location. Parents should research and explore all available options to find the best fit for their child and family.

GoldenCare Can Help

If you have a child with autism spectrum disorder, you are not alone. Skilled therapists are waiting to help you and your child. They can help prepare your child for the world by using ABA therapy techniques to teach them important skills and encourage beneficial behaviors that they’ll use their whole life.

Don’t let your child fall behind. With the new Medicaid services available in New Jersey, your child can get the therapy they need without you having to worry about the cost.



If you are ready to work with the best ABA therapy provider in New Jersey, give us a call at (732) 402-0297. Our dedicated team is ready to help and we will treat you like family.

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