Higglo digital

Insurance Guide · Maine (ME)

ABA Therapy Insurance in Maine

$36,000 per year (under age 10) · L.D. 1198 (2010)

Annual Cap

$36,000 per year (under age 10)

Age Limit

Through age 10

Plan Types

Individual and group fully-insured plans

Maine Mandate Details

Mandate Law

L.D. 1198 (2010)

Year Enacted

2010

Medicaid Coverage in Maine

Maine Medicaid (MaineCare) covers ABA therapy for children under 21 with an autism diagnosis through EPSDT.

What to Know About ABA Coverage in Maine

Maine's mandate caps ABA coverage at $36,000 per year and applies through age 10, one of the most restrictive age limits. MaineCare provides additional coverage for eligible children through age 21.

Frequently Asked Questions

What is Maine's annual cap for ABA insurance coverage?

Maine caps ABA insurance coverage at $36,000 per year under the commercial mandate, with coverage applying through age 10.

Why does Maine's mandate only cover through age 10?

Maine's original mandate focused on early intervention. While the commercial mandate covers through age 10, MaineCare (Medicaid) covers ABA through age 21 under EPSDT, and many commercial plans voluntarily extend coverage beyond the mandate.

Does MaineCare cover ABA therapy?

Yes. MaineCare covers ABA therapy for children under 21 with an autism diagnosis through EPSDT. This provides an important coverage pathway beyond the commercial mandate's age 10 limit.

Higglo

Need help navigating ABA insurance?

Our team works with ABA providers across Maine.