Paying for ABA Therapy: Insurance & EIDBI
Key takeaways
- ABA therapy is covered for qualifying Minnesota children through EIDBI, a Medical Assistance (Medicaid) benefit.
- Neurolink Academy accepts four MA plans: Straight MA, HealthPartners PMAP, Blue Cross Blue Shield PMAP, and MA TEFRA.
- For most EIDBI families, therapy comes at no out-of-pocket cost.
- TEFRA can open Medical Assistance for a child with a disability even when family income is too high for regular MA.
- We verify your child's coverage before the first session. Tell us the plan name and we do the rest.
Medical Assistance comes in two flavors. We take both.
Medical Assistance (MA) is Minnesota’s Medicaid program, and it reaches families two ways. Knowing which one your child has makes every conversation easier; not knowing is also fine, because we will figure it out with you.
Straight MA, directly through the state
Your child’s MA is billed directly to the Minnesota Department of Human Services, with no health plan in between. County workers often call this “straight MA” or “FFS MA.” Families on Straight MA can see any MHCP-enrolled EIDBI provider in the state, with no network restriction.
MA through a health plan
PMAP (Prepaid Medical Assistance Program) means your child’s MA is delivered through a health plan. The benefit is the same Medicaid coverage; the plan manages it. We are in network for HealthPartners PMAP and Blue Cross Blue Shield PMAP (Blue Plus).
The four plans we accept
All four are forms of Minnesota Medical Assistance, and all four cover EIDBI services for qualifying children. We are not in network with commercial or private insurance plans at this time.
Medical Assistance (Straight MA)
STRAIGHT MA · AcceptedYour child has Medical Assistance directly through the state, with no health plan in the middle. Often called "straight MA" or "fee-for-service" by county workers. Families on Straight MA can see any MHCP-enrolled EIDBI provider, with no network restriction.
HealthPartners PMAP
HP PMAP · AcceptedYour child’s Medical Assistance is delivered through HealthPartners. PMAP stands for Prepaid Medical Assistance Program: same Medicaid benefit, managed by a health plan. If your child’s insurance card says HealthPartners and they qualify through MA, this is likely you.
Blue Cross Blue Shield PMAP
BCBS PMAP · AcceptedYour child’s Medical Assistance is delivered through Blue Plus, the Blue Cross and Blue Shield of Minnesota Medicaid plan. Same EIDBI benefit, managed through Blue Cross.
MA TEFRA
MA TEFRA · AcceptedMedical Assistance through the TEFRA option (sometimes called Katie Beckett). It lets children with disabilities qualify for MA based on the child’s needs, even when family income would otherwise be too high.
On a different plan, or not sure your child qualifies for MA? Contact us anyway. TEFRA in particular surprises many families; the next section explains why.
Could TEFRA open Medical Assistance for your child?
Many parents assume their income disqualifies their child from Medicaid, and stop there. TEFRA exists for exactly this situation. Sometimes called the Katie Beckett option, it lets a child with a disability qualify for Medical Assistance based on the child's own needs and income, not the household's.
For a family whose commercial plan does not cover intensive ABA (or covers it with heavy cost-sharing), TEFRA can be the path that makes EIDBI-funded therapy possible. Families apply through their county; a parental fee based on income may apply. We accept MA TEFRA, and our intake team can tell you whether it is worth exploring for your child.
Source: MN DHS TEFRA option.
TEFRA in one sentence
If your child has a qualifying disability, they may get Medical Assistance even if your family earns too much for regular MA, and that MA covers EIDBI therapy.
HealthPartners PMAP ABA coverage
If your child's Medical Assistance is delivered through HealthPartners, their EIDBI benefit works here. Coverage includes the CMDE, the treatment plan, intensive therapy hours, and parent training, the same Medicaid benefit, managed by HealthPartners. We are in network and handle the authorization paperwork with the plan directly.
Unsure whether your HealthPartners card is PMAP or a commercial plan? Ask us; the distinction matters and takes us minutes to check.
Blue Cross Blue Shield PMAP ABA coverage
Blue Plus is Blue Cross and Blue Shield of Minnesota's Medicaid plan. If your child's card says Blue Plus and they qualified through Medical Assistance, EIDBI services at Neurolink Academy are covered the same way: evaluation, treatment plan, therapy hours, and parent training, with authorization managed between us and the plan.
Commercial Blue Cross plans are a different product; we are not in network with those. The card name tells the story, and we can read it with you.
What families typically pay: for most, nothing
Medical Assistance covers EIDBI services without cost-sharing for eligible children. That includes the intensive therapy hours, the CMDE evaluation, the treatment plan, and parent training. For most EIDBI families, the out-of-pocket cost of therapy is zero dollars.
This is why we lead with EIDBI and Medical Assistance instead of burying them in fine print. Access to therapy should not depend on which plan your family is on, and at Neurolink Academy it does not.
Let us do the verifying
Tell us your child’s plan name and we will confirm eligibility, explain what EIDBI covers, and flag anything that needs to happen before the first session.
DHS-enrolled EIDBI provider
EIDBI benefits are administered by the Minnesota Department of Human Services. Learn more on the EIDBI services page.
How to read your child's Medicaid card
The fastest way to know which plan your child has is sitting in your wallet. Here is what the card usually tells you.
A state-issued MHCP card
If your child's card is the Minnesota Health Care Programs card from the state, with no health-plan logo, your child likely has Straight MA (fee-for-service).
Likely Straight MAA HealthPartners card
If the card carries the HealthPartners name and your child qualified through Medical Assistance, your child is likely enrolled in HealthPartners PMAP.
Likely HP PMAPA Blue Plus card
Blue Plus is Blue Cross and Blue Shield of Minnesota's Medicaid plan. A Blue Plus card on an MA-qualified child usually means Blue Cross PMAP.
Likely BCBS PMAPNot sure what you have?
Plan names are genuinely confusing, and cards change. Tell us the plan name printed on the card, and we will sort out the rest.
We can checkVerifying coverage takes minutes, not weeks
One more thing to know: EIDBI-funded therapy starts with a CMDE evaluation and an authorization. Neither needs to be done before you contact us. Our CMDE guide explains the evaluation, and our team walks you through authorization when the time comes.
Find your child’s card
Look at your child’s insurance card. The plan name (state MA, HealthPartners, or Blue Plus) tells most of the story.
Or simply ask us
Send us the plan name through our intake form or call us. We verify EIDBI eligibility and benefits on our end, usually within one business day.
We confirm before you commit
You will know exactly how therapy is covered before the first session. No surprise bills, no fine print.
After we verify: from coverage to first session
Confirmed coverage is the green light, not the finish line. Three steps remain, and we work them with you.
The CMDE establishes eligibility
If your child does not yet have a Comprehensive Multi-Disciplinary Evaluation, we point you to qualified evaluators and help you prepare. The CMDE itself is covered for eligible children.
Authorization is requested
The evaluation and treatment recommendation go to your child's plan for authorization. We handle the provider-side paperwork and track the request.
First session at our clinic
Your BCBA reviews the treatment plan with you, scheduling is set, and sessions begin at our Brooklyn Park center — delivered by a behavior technician and supervised by a BCBA.
Wondering what the sessions themselves look like? See our Brooklyn Park center, our early intervention program for young children, and who we are as a provider.
Insurance questions, answered plainly
Cost is the number one worry families bring to us. Here is the honest picture.
Yes, gladly. Neurolink Academy is a DHS-enrolled EIDBI provider and we accept Medical Assistance in four forms: Straight MA (fee-for-service), HealthPartners PMAP, Blue Cross Blue Shield PMAP (Blue Plus), and MA TEFRA. Many Twin Cities ABA providers do not accept Medicaid; we built our practice around welcoming it.
Some commercial plans in Minnesota do cover ABA therapy, and coverage details vary by plan. Neurolink Academy is not in network with commercial or private plans at this time. If your child may qualify for Medical Assistance (including through TEFRA), our intake team can help you understand that path.
For most EIDBI families, nothing. Medical Assistance covers EIDBI services without cost-sharing for eligible children, which means covered therapy, the evaluation, and parent training typically come at no cost to the family. We confirm your child’s exact coverage during intake, before therapy begins.
The easiest way: tell us the plan name from your child’s insurance card and let us check. We verify eligibility and EIDBI benefits on our end. You can also call the member services number on the card and ask whether the plan covers EIDBI services.
EIDBI-funded therapy requires a CMDE (Comprehensive Multi-Disciplinary Evaluation) to establish medical necessity, followed by an authorization. You do not need either one to contact us; we help families navigate both steps and handle the provider-side paperwork.
Contact us anyway; it costs nothing to ask. Minnesota families can often switch their Medical Assistance health plan during open enrollment or qualifying windows, and a child with a disability may qualify for MA through TEFRA regardless of household income. We will give you an honest read of your options, and if we are not the right fit, we will say so and point you somewhere helpful.
Start your child’s intake today
Connect with our BCBA team. We confirm your EIDBI coverage and match your child with the right clinician. Intake takes about five minutes.
- BCBA-led from day one
- EIDBI · Medical Assistance covered
- Intake in about 5 minutes