We verify first
Give us your Kaiser member ID and we'll confirm whether your plan covers ABA, whether you're fully insured or self-funded, what your out-of-pocket exposure looks like, and what the referral pathway requires.
We navigate the referral
Kaiser typically requires a referral from your child's primary care physician before ABA therapy can begin. We walk you through what that referral needs to say and how to get it submitted correctly.
We submit prior authorization
Kaiser requires prior authorization before ABA services start. We submit the full clinical documentation package and follow up until approval comes through.
We explain your real costs
Unlike Medicaid, Kaiser plans involve deductibles, copays, and out-of-pocket maximums. Before your child's first session, you'll know exactly what your plan pays and what your family owes. Some Kaiser Colorado silver-tier HMO plans carry a $50 copay per ABA session with no annual visit limit. Your plan may be structured differently. We confirm the real numbers based on your actual plan documents.
Does Kaiser Permanente cover ABA therapy in Colorado?
Yes, under Colorado's autism insurance mandate. With some important caveats.
Colorado's autism insurance law, Senate Bill 09-244, requires fully insured commercial health plans to cover ABA therapy for children with an autism diagnosis. Kaiser Permanente Colorado's fully insured plans are subject to this mandate, with an annual cap of $34,000 per year. Coverage requires a formal ASD diagnosis, a physician referral, and prior authorization.
The self-funded exception
Colorado's state mandate does not apply to self-funded employer plans, which are governed by federal ERISA law. If your Kaiser coverage comes through your employer, it's worth confirming whether the plan is fully insured or self-funded. Blossom ABA checks this during benefits verification so your family knows before therapy begins.
Kaiser's closed network
Kaiser operates as an integrated closed-network system, which means the referral and authorization process runs differently from standard commercial plans. We verify your specific plan's network rules and referral pathway during benefits verification.
Initial assessment
A comprehensive behavioral assessment by a BCBA to document your child's current skills and build a treatment plan. Required before authorization and covered under Kaiser's ABA benefit.
Direct ABA therapy
One-on-one sessions with a Registered Behavior Technician under BCBA supervision, in your home, up to the authorized level within the annual $34,000 cap.
BCBA supervision and parent training
Both covered components of the ABA benefit under Colorado's mandate.
Annual cap
Colorado's autism insurance mandate sets a $34,000 annual cap for ABA therapy under commercial plans. This is structurally different from Medicaid, which has no fixed cap. Blossom ABA tracks your child's utilization against the cap and flags it before it becomes an issue.
Does my Kaiser plan definitely cover ABA therapy?
Do I need a referral from my Kaiser doctor first?
What does ABA therapy cost with Kaiser?
Is there an annual limit on ABA hours under Kaiser?
My employer provides Kaiser. Does the mandate apply?
What if Kaiser denies the authorization?
Still have questions?
