ABA therapy with Aetna, in-network in Miami-Dade
Beaton Care Services is contracted with Aetna for ABA therapy. We verify your child's benefits, obtain Aetna's precertification and give you a written cost estimate before the first session. Sessions at home or at school, in English or Spanish.
Does Aetna cover ABA therapy?
Yes, for members with an autism spectrum disorder diagnosis. Aetna considers applied behavior analysis medically necessary for the treatment of autism when its clinical criteria are met, and Florida's autism coverage law applies to state-regulated Aetna group plans. Aetna CVS Health plans sold on the Marketplace in Florida cover ABA as a habilitative essential health benefit.
As with any employer coverage, a self-funded plan follows the employer's own benefit design rather than Florida law. Most include ABA, but limits and cost-sharing differ, which is why we check the exact plan on your child's card and send you the answer in writing before scheduling anything.
What Aetna typically requires
A documented autism spectrum disorder diagnosis from a qualified professional and a referral for ABA from your child's physician. Aetna then requires precertification: first for the behavioral assessment, then for treatment based on the BCBA's treatment plan, which must include measurable goals, the recommended hours and a caregiver-training component.
Treatment authorizations are approved for a defined period (commonly six months) and renewed on a progress report that shows the data. Aetna manages behavioral-health benefits, including ABA, through its own behavioral-health unit, and we submit directly to it.
What you will pay
In-network ABA on an Aetna plan follows your plan's normal cost-sharing: the deductible first, then a copay or coinsurance per session until the out-of-pocket maximum, after which the plan pays in full for the rest of the plan year. Under state and federal parity rules, ABA cost-sharing cannot be less favorable than what the plan applies to comparable medical care.
ABA usually means several sessions a week, so after the benefits check we send you an estimate of your expected cost for the authorized hours, and we update it when the deductible resets.
Aetna vs. Aetna Better Health: not the same plan
Aetna Better Health of Florida is Aetna's Medicaid managed-care plan and follows Florida Medicaid's ABA rules: a comprehensive diagnostic evaluation, a physician order, and six-month authorizations under the state coverage policy. Commercial Aetna plans (through an employer or the Marketplace) follow Aetna's own clinical policy and your plan's cost-sharing. We are contracted with both. If you are not sure which one you have, the card says it: Medicaid cards read "Aetna Better Health".
At home, at school, in your language
We deliver ABA where the behavior happens: in your home, in your child's school or preschool when the plan and the school allow it, and in our Kendall office for assessments. Our BCBAs and most of our technicians are bilingual, and caregiver training is delivered in the family's language.
From first call to first session with Aetna
- 01
Benefits check
Call us or request a call back with the plan name on your card. Within one to two business days we confirm ABA coverage, network, deductible, copay and precertification rules, in writing.
- 02
Diagnosis and referral
A documented autism diagnosis and a physician referral for ABA. Already have them? Send them over. If not, we point you to evaluators in Miami-Dade with the shortest waits.
- 03
Assessment and precertification
Our BCBA assesses your child, writes the treatment plan and submits the precertification to Aetna. We answer the plan's clinical questions and follow the request until it is approved.
- 04
Therapy begins
A Registered Behavior Technician works with your child, supervised by the BCBA, with caregiver training built in. We track the renewal date so hours never lapse.
Aetna and ABA: common questions
Is Beaton Care in-network with Aetna?
Yes, for ABA therapy on commercial Aetna plans, and separately with Aetna Better Health for Florida Medicaid. Employer plans can use different Aetna networks, so we confirm the network on your specific card before the first visit.
Does my child need an autism diagnosis before ABA can start?
Yes. Aetna's coverage criteria for ABA require an autism spectrum disorder diagnosis by a qualified professional. We can help you find an evaluator quickly if you do not have one yet.
How long does Aetna precertification take?
In our experience most decisions arrive within two to three weeks of a complete submission; urgent requests can be faster. We submit complete the first time, which is what shortens it.
How many hours will Aetna approve?
Hours follow medical necessity as documented in the BCBA's assessment and treatment plan, not a fixed cap. Plans commonly range from 10 to 30 hours per week and are reviewed at each renewal.
Can sessions happen at my child's school?
Often, yes. Most plans cover ABA in the settings where the goals are worked on, and we coordinate with the school. We confirm it in the benefits check so you know before we plan the schedule.
Let’s verify your coverage
A bilingual member of our team responds within one business day.
- No diagnoses or insurance ID numbers, just how to reach you
- A bilingual BCBA calls you, not a call center
- We check your plan and tell you exactly what’s missing
Beaton Care Services is an independent ABA therapy provider contracted with Aetna. This site is not operated by or affiliated with Aetna. Plan information is general; confirm the details of your coverage with your plan.