Cigna ABA therapy coverage

Yes, for autism, when all of Cigna's medical necessity criteria are met. Cigna does not cover ABA for other conditions, including Rett syndrome. Your plan document always wins if it differs.

Read the Cigna policy

A parent on the phone to Cigna, with the insurance card and a notepad

What the Cigna policy says

Policy: Cigna Healthcare (Evernorth) Coverage Policy EN0499: Intensive Behavioral Interventions, effective 5/15/2026 Source: Cigna Healthcare (Evernorth).
Coverage: Yes, for autism, when all of Cigna's medical necessity criteria are met. Cigna does not cover ABA for other conditions, including Rett syndrome. Your plan document always wins if it differs. Source: Cigna Healthcare (Evernorth).
Diagnosis: Your child needs a confirmed autism diagnosis based on DSM-5-TR from a licensed professional who can diagnose on their own. The request must list that person's name, credentials, and license type. Source: Cigna Healthcare (Evernorth).
Prior authorization: Yes. The ABA provider sends Cigna an authorization request to start ABA and another to continue it. A start request is used when the child has not had ABA with that provider in the past 90 days. Source: Cigna Healthcare (Evernorth).
Progress reviews: Each request to continue ABA must include progress data from the last 60 days. It must also include a standard skills test done within the past year. Source: Cigna Healthcare (Evernorth).
Hours: There is no set number of hours. Hours are decided for each child based on test results and how severe their needs are. Source: Cigna Healthcare (Evernorth).
Who can provide it?: A BCBA, a Licensed Behavior Analyst (LBA), or a licensed mental health clinician trained in ABA must do the assessment. Supervision should be about 1 to 2 hours for every 10 hours of therapy. Source: Cigna Healthcare (Evernorth).

Some states require plans to cover ABA. Cigna does not pay for services that are mainly educational, or for ABA given at the same time as another therapy like speech. Parents and caregivers should get training as part of care. Source: Cigna Healthcare (Evernorth).

Before the first session, ask Cigna three things

Is ABA a covered benefit on my plan, and is my plan fully insured or self-funded?
Which ABA providers near me are in network?
What will I pay per session after the deductible, and what is my out-of-pocket maximum?

The member number on your card is all they need. Then use the list for your city and ask each provider whether they're in network with your plan.

ABA therapy providers by city

Other plans: TRICARE, Aetna, Blue Cross and Blue Shield (Excellus BCBS, New York), UnitedHealthcare (Optum Behavioral Health), Medicaid by state.