By Yasamin Yousefi, Founder & CEO, SenseBloom Therapy· Last reviewed September 30, 2026
Short answer: Sometimes. Coverage for ABA depends on the wording of your plan, not on a general rule, so the quickest way to a real answer is a written reply from your insurer before you start paying for sessions.
- Plans usually cover by profession, so what matters is whether your insurer lists behaviour analysts (or covers ABA when a psychologist supervises it).
- Receipts need the provider’s name, designation and registration number, or claims get bounced.
- A short email, like the one below, gets you an answer you can point to later.
Plenty of parents assume that a plan covering physiotherapy or counselling will also cover ABA, then learn otherwise after the first invoice. The plan document is the only thing that settles it, and this page shows you what to look for and what to ask.
Why the answer differs from plan to plan
Insurers tend to organize benefits by the profession of the person delivering the service, such as psychologist, speech-language pathologist or occupational therapist. Behaviour analysis is newer to that picture in Ontario. Since July 1, 2024, only practitioners registered with the College of Psychologists and Behaviour Analysts of Ontario (CPBAO) can use the title “Behaviour Analyst,” and the Canada Revenue Agency now lists behaviour analysts as authorized medical practitioners in Ontario for the medical expense tax credit.
Neither change obliges your insurer to update its own list. Whether yours has is something only your insurer can tell you.
What to ask
Ask these four questions:
- Is ABA or behaviour analysis an eligible service, and under which benefit (psychology, paramedical, mental health or something else)?
- Are registered behaviour analysts eligible practitioners? If not, does coverage change when a registered psychologist supervises the program?
- What is the annual maximum, and does it reset on the calendar year or the plan year?
- Do you need a referral, treatment plan or letter of recommendation, and from whom?
A sample email you can send
Subject: Coverage question for ABA therapy: policy [number]
Hello,
My child is starting applied behaviour analysis (ABA) therapy with a provider registered with the College of Psychologists and Behaviour Analysts of Ontario. Before we begin, could you confirm in writing:
- Whether ABA therapy is an eligible service under my plan, and under which benefit.
- Whether registered behaviour analysts are eligible practitioners.
- The annual maximum and when it resets.
- What documents you need with each claim (receipt details, referral, treatment plan).
Thank you, [Name, member ID]
Keep the reply. If a claim is denied later, a written answer is much stronger than your memory of a phone call.
What your receipts should show
Insurers want to see who delivered the service and in what role. Ontario asks for a similar set of details on OAP letters of recommendation: the professional’s full name, employer, professional designation (for example, Registered Behaviour Analyst) and licence number. Receipts that include those details, plus the service, date and fee, are far less likely to be rejected.
If a technician delivers the session under a behaviour analyst’s supervision, ask the clinic whose name and registration number appear on the receipt, and confirm with your insurer that this matches what they accept.
How to submit a claim
- Get eligibility confirmed in writing first.
- Ask the clinic for itemized receipts, and a treatment plan summary if your insurer wants one.
- Collect a referral if your plan requires it.
- Submit through your insurer’s portal or app with everything attached.
- Note the submission date and reference number, and follow up if nothing has come back in two or three weeks.
If a claim is denied
Read the stated reason before anything else. “Practitioner not eligible” and “annual maximum reached” are different problems from “missing documents,” and only the last is quickly fixable. Ask for the policy clause the insurer is relying on, correct any missing paperwork and resubmit, and then use the insurer’s formal appeal process. If the plan comes through your employer, your benefits administrator can often press the insurer on your behalf.
Using insurance alongside other funding
Insurance can sit alongside OAP funding and tax credits, but don’t guess about overlap. Before you submit the same sessions to an insurer and to AccessOAP, ask both how they handle it. For the medical expense tax credit, only what you paid and weren’t reimbursed for counts, so subtract any insurance payout. Ontario.ca explains how OAP funding and reporting work.
If your insurer asks what ABA actually involves, our overview of applied behaviour analysis is a plain-language place to start. If your child also sees a speech-language pathologist, a profession insurers often cover on its own, see how speech therapy and ABA therapy work together.
Questions about our clinic
SenseBloom offers clinic-based ABA therapy programmes, in home ABA therapy, speech therapy and ABA therapy in North York as well as behaviour intervention services. If you’d like to know what documentation we provide, request a consultation.
Frequently asked questions
Why would an insurer say no when it covers speech therapy? Coverage is usually written around specific professions. If behaviour analysts aren’t on your plan’s list, ABA can be declined even though similar services are covered.
Do I need a referral? It depends on the plan. Some want a referral or treatment plan from a physician, psychologist or the treating clinician. Put the question in your email.
Will the clinic bill my insurer directly? Clinics differ, and many families pay first and claim afterward. Ask before you start so there are no surprises on the first invoice.
What if my annual maximum is small? Ask which sessions are best to claim first, combine sources where the rules allow, and check your eligibility for OAP funding and the tax credit.
Can I claim the same sessions on insurance and on my taxes? Only the part you paid and weren’t reimbursed for counts toward the tax credit. Confirm the details with an accountant.
Sources
- CPBAO, ABA regulation FAQs: https://cpbao.ca/resources/faqs/
- CPBAO, CRA medical expense tax credit recognition: https://cpbao.ca/canada-revenue-agency-cra-medical-expense-tax-credit/
- Canada.ca, authorized medical practitioners for the medical expense tax credit
- Ontario.ca, core clinical services (letter-of-recommendation details): https://www.ontario.ca/page/ontario-autism-program-core-clinical-services
General information only, not insurance, legal or tax advice. Your policy documents take priority.
