MedCost ABA Therapy Coverage in North Carolina & Virginia
One Less Thing to Deal With
Having a child with autism means wanting the best support so they can shine the way you know they can. At Connect N Care ABA, we ensure MedCost coverage won't stand in the way of your child's progress.
You need a reliable team that understands your child's needs and takes care of the insurance process, so you can focus on the only thing that counts.
What we do with your MedCost plan:
- Verify benefits before your first appointment
- Submit authorizations and handle follow-ups
- Manage claims, reauthorizations, and appeals
How We Work With MedCost
At Connect N Care ABA, we manage the insurance process so you can focus on what really matters: your child's therapy. We handle the paperwork, approvals, and everything in between, ensuring you don't waste time on confusing billing codes or authorization requirements.
We verify first
Give us your MedCost details, and we'll confirm exactly what's covered before you commit to therapy. No surprises later about what MedCost
will or won't pay for.
We submit authorization requests
MedCost
requires prior authorization for ABA therapy. We know exactly what paperwork they need, how to format it, and who to follow up with when they’re slow to respond.
We break down your costs
Before therapy begins, you’ll know exactly what MedCost
will cover and what you’ll need to pay. Real numbers, not estimates.
We handle the administrative chaos
Submitting claims, resubmitting when paperwork is missing, appealing denials—Connect N Care ABA handles everything so you don’t have to.
What MedCost Covers for ABA Therapy
One-on-one therapy with a trained RBT, right in your home. Your child works on communication, behavior regulation, and skill-building in the environment they need it most.
Structured, individualized therapy delivered at our dedicated clinic. Your child receives focused support with a team of trained professionals, access to specialized materials, and a consistent therapy setting designed for growth.
Therapy during your child’s school day—in the classroom, during lunch, and at recess. We help them succeed in real situations: participating in group work, managing frustration, and navigating peer relationships.
You’ll learn the same strategies our therapists use, so you can reinforce skills at home. You’ll know how to support your child’s progress between sessions.
How to Get Started with ABA Covered by MedCost
1. Contact Connect N Care ABA
Call us or fill out our contact form. We'll need your MedCostmember ID and your child's autism diagnosis documentation.
2. We contact MedCost
We verify your benefits directly with MedCost to give you clear answers and coverage.
4. Your child starts therapy
Once MedCost approves coverage, we schedule your child's first session, in your home or at school, based on your family's needs and schedule.
3. We submit authorization
We prepare and submit the prior authorization request with all required clinical documentation. Then we follow up with MedCost until they process it.
Why Families with MedCost Trust Connect N Care ABA
Expert knowledge: We know how MedCost works. We've processed hundreds of MedCost authorizations and understand their documentation.
We handle the paperwork: You don't need to become fluent in insurance terminology. We manage the whole process - from verification to final claims.
Clear cost information: You'll know your costs upfront before therapy begins, not vague estimates that turn into surprise bills later.
Therapy where it matters most: Whether in your home or at school, therapy happens in real settings, with real-world challenges.
We're direct: If MedCost denies coverage, we'll explain the real reason and appeal with the right documentation.
What will ABA therapy cost with my insurance plan?
It depends on your specific plan details. Some families pay only their premium, while others have copays, deductibles, or coinsurance. We verify your exact financial responsibility before therapy begins.
Does my plan require a pediatrician referral?
Some MedCost plans require it, others don’t. We’ll verify your specific plan’s requirements and help you get any necessary referrals.
What documentation do I need for authorization?
Typically, we’ll need an official autism diagnosis, a treatment plan from our BCBA, and completed prior authorization forms. Sometimes MedCost asks for additional records. We handle all the submissions and follow-ups.
How long before my authorization is approved?
Usually 7-14 business days. We’ll keep you updated and push for expedited approvals when possible.
How many therapy hours will I get authorized?
Most plans approve 10-40 hours per week, depending on clinical necessity. We request what your BCBA recommends, and if fewer hours are approved, we appeal the decision.
What happens if my coverage is denied?
We’ll help you appeal denials with additional clinical documentation. Most denials are overturned with the right supporting information.
Can I use HSA or FSA funds?
Yes. ABA therapy qualifies as a medical expense, so you can use HSA or FSA funds for copays, deductibles, and out-of-pocket costs.
If I don't have active insurance, can Connect N Care ABA still help?
We work with most major insurance providers in North Carolina and Virginia. If you have a different plan, we may still be able to help. We also offer self-pay options if you don’t have insurance.
Does insurance cover ABA therapy for non-autism diagnoses?
Some MedCost plans cover ABA therapy for conditions like ADHD. We’ll verify what your specific plan covers.
Does insurance coverage ever run out?
Most plans continue coverage as long as therapy is medically necessary. We monitor your benefits and keep you informed about coverage status.
Is Connect N Care ABA in-network with my insurance plan?
We work with MedCostthroughout North Carolina and Virginia. We’ll confirm whether we’re in-network for your specific plan during benefits verification.
When does my insurance authorization expire?
Most plans authorize therapy in 3-6 month periods. We track expiration dates and submit renewal requests early to avoid service interruptions.
MedCost Coverage FAQs
Let's Get You Covered
Navigating insurance can be overwhelming. That's why we're here to help you every step of the way. Let's make sure your child gets the ABA therapy they need without the insurance headaches.
