MedCost ABA Therapy Coverage in North Carolina

MedCost & ABA Therapy in North Carolina

MedCost is a North Carolina-based health plan administrator that manages employer-sponsored health benefits for businesses across the state. If your employer offers a MedCost plan, ABA therapy may be covered as part of your behavioral health benefits.

Coverage Details

MedCost-administered plans typically cover ABA therapy when it is medically necessary for a child diagnosed with Autism Spectrum Disorder. Coverage varies by employer plan but commonly includes:

• Diagnostic assessments — Evaluations and Functional Behavior Assessments
• Individual ABA therapy — One-on-one sessions with a trained Behavior Technician
• BCBA supervision — Treatment planning and oversight by a Board Certified Behavior Analyst
• Parent training sessions — Caregiver coaching to help your child generalize skills at home
• Treatment plan reviews — Regular updates and progress monitoring

Because MedCost administers employer-specific plans, coverage details including session limits, copays, and deductibles can vary. Our team will confirm your exact benefits before services begin.

Prior Authorization

Most MedCost plans require prior authorization for ABA therapy. Our intake team handles the authorization process directly, including submitting required clinical documentation and managing reauthorization requests as your child’s treatment continues.

Verification

Contact us and we’ll verify your MedCost benefits within 48 hours. We review your specific plan details, confirm in-network status, and clarify any cost-sharing requirements so you know exactly what to expect.