Question 1

Does Delaware Medicaid cover ABA therapy?

Accepted Answer

Yes, Delaware Medicaid covers ABA therapy for children and teens under 21 who have an autism spectrum disorder diagnosis. Coverage is provided through managed care plans at no cost to eligible families.

Question 2

What is the age limit for ABA therapy under Delaware Medicaid?

Accepted Answer

Delaware Medicaid covers ABA therapy for individuals under 21 years old, as required by the federal EPSDT mandate.

Question 3

Does Delaware Medicaid cover ABA therapy for adults over 21?

Accepted Answer

Standard Delaware Medicaid does not cover ABA therapy for adults over 21. Some adults may qualify for behavioral services through Medicaid Home and Community Based Services (HCBS) waiver programs.

Question 4

How do I find ABA providers that accept Delaware Medicaid?

Accepted Answer

Use FindABA to search for ABA therapy providers in Delaware that accept Medicaid. You can also contact your Medicaid managed care plan directly for a list of in-network providers.

Question 5

Does Delaware Medicaid require prior authorization for ABA therapy?

Accepted Answer

Yes, prior authorization is required for ABA therapy through Delaware Medicaid. Your ABA provider will submit the treatment plan to your managed care plan, and authorization typically takes 7–14 business days.

Does Medicaid Cover ABA Therapy in Delaware?

Delaware Medicaid managed care plans

Delaware's autism insurance mandate

How to access ABA through Delaware Medicaid

Delaware resources