Does Alliance Health cover ABA Therapy?
iCare Therapy accepts North Carolina Medicaid and most major insurers, and Alliance Health is one of the plans we work with. Whether ABA Therapy is covered for your child, how many hours are approved and what your share of the cost is all depend on your specific plan and your child’s diagnosis. We verify all of that for you before anything begins, at no cost and with no commitment, and we tell you the answer in writing.
This page explains what Alliance Health is, what has to be in place before therapy can start, and what iCare Therapy handles on your behalf.
Tell us about your family
What Alliance Health is
Alliance Health is a Tailored Plan, one of the organizations North Carolina uses to manage Medicaid behavioral health, intellectual and developmental disability, and substance use services for members with more complex needs. It covers Cumberland, Durham, Harnett, Johnston, Mecklenburg, Orange and Wake counties. If your child lives in Charlotte or anywhere else in Mecklenburg and is on Medicaid, the behavioral health part of that coverage, which includes ABA Therapy, runs through Alliance rather than through the state directly.
The distinction matters because a Tailored Plan is not the same thing as the Standard Plans most families hear about first. Tailored Plan members typically have a diagnosis that qualifies them for a higher level of care coordination, and they are usually assigned a named care coordinator whose job includes helping services get authorized. For a family trying to start ABA Therapy, that coordinator is a real asset, and one of the first things iCare Therapy does is find out who yours is.
The distinction matters because a Tailored Plan is not the same thing as the Standard Plans most families hear about first. Tailored Plan members typically have a diagnosis that qualifies them for a higher level of care coordination, and they are usually assigned a named care coordinator whose job includes helping services get authorized. For a family trying to start ABA Therapy, that coordinator is a real asset, and one of the first things iCare Therapy does is find out who yours is.
Who this page is for
This page is for the parent or caregiver of a child or young adult with an autism diagnosis, living in Mecklenburg County, whose Medicaid coverage is managed by Alliance Health, and who wants to understand what has to happen before ABA Therapy can begin. It is also for the pediatrician, care coordinator or diagnostician who is about to refer a family and wants to know what iCare Therapy needs in order to accept that referral cleanly.
If your child lives in Iredell County, which includes Statesville, Troutman and Mooresville, or in Gaston County, which includes Belmont, your Tailored Plan is Vaya Partners rather than Alliance Health, and there is a separate page for that. The county on your address decides which plan applies, and iCare Therapy serves both.
Not sure what your plan covers?
We will check it, free.
What your family needs before therapy can start
Three things have to be in place before ABA Therapy can begin, and they arrive in a fixed order. First, a diagnosis of autism spectrum disorder from a qualified evaluator, which in North Carolina is usually a developmental pediatrician, a child psychologist or a psychiatrist. Second, a referral, which most often comes from your child’s pediatrician and simply says that ABA Therapy is medically indicated. Third, prior authorization, which is the plan agreeing in writing to cover a specific number of therapy hours over a specific period.
Most families arrive with the first, get the second within a phone call, and then stall on the third. Prior authorization is where paperwork goes to wait, and it is the single most common reason a family who was ready in June is still not in therapy in September. It is also the part iCare Therapy handles for you. Once we have your diagnostic report and your insurance card, we assemble the request, submit it, and follow it up so that you are not the person on hold with the plan.
If your child does not yet have a diagnosis, start there. Ask your pediatrician for a referral to a developmental evaluation. Waitlists for evaluation are real in the Charlotte area, so getting on one now is worth more than any amount of planning about therapy that cannot start until it is done.
How long authorization takes
Authorization timelines are set by the plan, not by the provider, and they vary with how complete the request is when it arrives. A request that carries a full diagnostic report, a clear referral and a treatment plan moves faster than one that has to be returned for a missing page.
iCare Therapy does not publish a number of weeks, because nobody controls the plan’s side of the process and a number on a website becomes a promise the moment a family reads it. What we do instead is tell you which step your request is at and what is being done about it, at any point, for as long as it takes. If a provider gives you a single confident number, ask them what happens when it is wrong.
What iCare Therapy does for your family
We verify your benefits before you commit to anything, so you know what is covered and what your share is before the first session, not after. We assemble the authorization request from your diagnostic report and our own assessment, submit it to the plan, and follow it up. If the plan asks for something more, we tell you what it is and, in most cases, we obtain it ourselves. If a request is denied, we tell you why in plain language and what the appeal route looks like.
Therapy itself happens in your home, in the rooms where the skills are actually used, with a virtual option when that suits your family better. A Registered Behavior Technician comes to you at a time you choose. A Board Certified Behavior Analyst writes the plan, supervises the sessions and adjusts the plan as your child progresses. Caregiver training is built in rather than added on, because a plan that only works when the therapist is in the room is not a plan.
Where we deliver care
iCare Therapy delivers care across thirty two zip codes in Mecklenburg, Iredell and Gaston counties, from Statesville and Troutman in the north to Indian Trail in the south, and west into Belmont. If you are not sure whether your address is inside the service area, the service area page lists every zip code, or a care coordinator can tell you in a minute over the phone.
