%20(33)%201%20(1).svg){kind=small}
Applied Behavior Analysis (ABA) can be life-changing for children with autism, but insurance can feel complicated. In Missouri, several laws and programs help—but there are still steps families should take to get coverage. Here’s what to know and how to work the system effectively.
If you are looking for ABA therapy in St Louis, reach out today.
What the Law Requires in Missouri
- Autism Insurance Mandate (HB 1311, HB 1341, and SB 514)
- Enacted in 2010, expanded in 2019, these laws require private insurers in many plan types (fully insured large and small groups, individual non-grandfathered plans) offer autism-related coverage, including ABA.
- The coverage includes diagnosis, ABA therapy (rehabilitative/habilitative care), therapeutic services, psychiatric/psychological services, etc.
- Enacted in 2010, expanded in 2019, these laws require private insurers in many plan types (fully insured large and small groups, individual non-grandfathered plans) offer autism-related coverage, including ABA.
- Age and Dollar Limits
- Coverage for ABA is required for insured individuals 18 years old and younger.
- There is an annual benefit cap for ABA therapy. In Missouri, this cap is adjusted yearly for inflation. As of 2025, that cap is $57,311.
- Coverage for ABA is required for insured individuals 18 years old and younger.
- MO HealthNet (Missouri Medicaid)
- Missouri’s Medicaid program—MO HealthNet—does cover ABA therapy for eligible children with autism.
- Missouri’s Medicaid program—MO HealthNet—does cover ABA therapy for eligible children with autism.
Common Roadblocks & Tips
- Self-insured plans: Missouri mandates may not apply; check employer benefits.
- Hour caps: Request an exception with provider documentation.
- Out-of-network rates: Ask the insurer for a single-case agreement.
- Age cutoffs: Explore private pay or Medicaid waivers for children over 18.
Missouri Resources & Help
- Missouri Department of Insurance — ABA benefit limits and autism resources.
- MO HealthNet — Medicaid coverage details.
References
- Autism Speaks – Missouri State-Regulated Insurance Coverage: https://www.autismspeaks.org/missouri-state-regulated-insurance-coverage
- Missouri Department of Insurance – ABA Limits: https://insurance.mo.gov/autism-and-related-insurance-resources/autism-report-aba-limits
- Atlas Autism Health – Missouri Insurance Information: https://www.atlasautismhealth.com/insurance
Share this post
