Children Under 21
Children from birth to age 20 in families meeting income requirements. Income limits vary by family size — for example, a family of four may qualify with household income up to approximately 138% of the Federal Poverty Level.
A comprehensive guide to Medicaid coverage for ABA services in Florida
Yes. Florida Medicaid covers Applied Behavior Analysis (ABA) therapy for children and eligible adults diagnosed with Autism Spectrum Disorder. ABA is considered a medically necessary treatment under Florida's Medicaid program, and coverage is provided through the state's Statewide Medicaid Managed Care (SMMC) managed care plans.
The Florida Agency for Health Care Administration (AHCA) oversees the Medicaid program and sets the standards for ABA coverage. Under federal EPSDT (Early and Periodic Screening, Diagnostic, and Treatment) requirements, Medicaid must cover all medically necessary services for children under 21 — including ABA therapy.
AIM Health is proud to accept Medicaid and works with families throughout Miami-Dade and South Florida to ensure their children receive the ABA services they need.
Apply online at myflorida.com/accessflorida. This is the fastest way to submit your application. You'll create an account, provide household and income information, and upload supporting documents. Processing typically takes 30–45 days.
Call the Florida Medicaid helpline at 1-866-762-2237 to request an application by phone or get assistance completing your application. Multilingual support is available.
Visit your local Department of Children and Families (DCF) office. Miami-Dade County has multiple DCF service centers where you can apply in person and receive help with documentation.
When you apply through the federal Health Insurance Marketplace, you may be automatically screened for Medicaid eligibility. If you qualify, your application will be forwarded to Florida's Medicaid program.
Note: Under EPSDT, there are no arbitrary limits on the number of ABA hours for children under 21 — coverage is based on medical necessity as determined by the treating BCBA and approved through the managed care plan.
Florida's Statewide Medicaid Managed Care (SMMC) program requires most Medicaid recipients to enroll in a managed care plan. These plans coordinate your care and handle authorizations. Common managed care plans in Miami-Dade County include:
One of the largest Medicaid managed care plans in Florida, offering comprehensive ABA coverage.
Provides Medicaid managed care services throughout South Florida with ABA benefits included.
A major managed care plan in Miami-Dade offering ABA therapy as a covered benefit.
Provides Medicaid managed care with behavioral health services including ABA therapy.
When choosing or changing your managed care plan, verify that the plan includes ABA as a covered benefit and that your preferred ABA provider (like AIM Health) is in-network. You can change plans during open enrollment or within 90 days of initial enrollment.
The Florida Agency for Health Care Administration (AHCA) is the state agency responsible for Medicaid. If you have issues with your managed care plan or need assistance, AHCA provides several resources: