ABA therapy with Florida Blue, in-network in Miami-Dade
Beaton Care Services is contracted with Florida Blue for ABA therapy. We verify your child's benefits, obtain the prior authorization and give you a written cost estimate before the first session, so there are no surprises. Sessions at home or at school, in English or Spanish.
Does Florida Blue cover ABA therapy?
In most cases, yes. Florida law requires state-regulated group health plans to cover the diagnosis and treatment of autism spectrum disorder, including applied behavior analysis delivered by certified providers, on terms no less favorable than those for other medical conditions. Marketplace (ACA) plans sold in Florida cover ABA as a habilitative essential health benefit, and federal mental-health parity rules apply to both.
The main exception is a self-funded employer plan, which is governed by federal rather than Florida law. Most large employers still include ABA, but the terms are the employer's. That is why we never assume: we run a benefits check on the exact plan on your child's card and tell you what it covers, in writing, before anything is scheduled.
What Florida Blue typically requires
A diagnosis of autism spectrum disorder from a qualified professional (a developmental pediatrician, pediatric neurologist, psychologist or psychiatrist), and a referral or prescription for ABA from your child's physician. Unlike Florida Medicaid, there is no requirement that the evaluation follow the Medicaid comprehensive-diagnostic-evaluation format, but the diagnosis must be documented.
With those in hand, our BCBA completes a behavioral assessment and writes the treatment plan. Florida Blue requires prior authorization for the assessment and for treatment, which is approved in blocks (commonly six months) and renewed on a progress report. On many Florida Blue plans, behavioral-health benefits such as ABA are managed by the plan's behavioral-health administrator rather than by Florida Blue directly; we know where each request goes and we submit it.
What you will pay
In-network ABA on a Florida Blue plan works like other in-network care: your deductible applies first (on a high-deductible or HSA plan that can mean the full allowed amount for the first sessions), then a copay or coinsurance per session until you reach the plan's out-of-pocket maximum, after which the plan pays in full for the rest of the year. On Marketplace plans, the metal tier (Bronze, Silver, Gold, Platinum) sets how large your share is.
Because ABA is often several sessions a week, the numbers matter. After the benefits check we send you an estimate of your expected cost for the authorized hours, and we revisit it whenever the deductible resets in January.
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 Florida Blue
- 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, your network, deductible, copay and authorization 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 authorization
Our BCBA assesses your child at home or in our office, writes the treatment plan and submits the prior authorization. We follow it 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.
Florida Blue and ABA: common questions
Is Beaton Care in-network with Florida Blue?
Yes, for ABA therapy. Florida Blue has several networks and products, and employer plans can use different ones, 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. Coverage under the Florida autism mandate and under plan policy is tied to 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 many hours will Florida Blue approve?
Hours are based on 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.
Do you handle the prior authorization?
Yes. We submit the assessment and treatment requests, respond to any clinical questions from the plan, and file renewals about 30 days before each authorization ends.
My plan is through my employer. Does the Florida law still apply?
It depends on whether the plan is fully insured (state-regulated, mandate applies) or self-funded (federal rules, employer decides). Most employers cover ABA either way; the benefits check tells us which rules apply to you.
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 Florida Blue. This site is not operated by or affiliated with Florida Blue. Plan information is general; confirm the details of your coverage with your plan.