Built specifically for autism and I/DD, not general healthcare
As a Tailored Plan, Vaya covers physical health, behavioral health, I/DD, and pharmacy under one plan and one care team.
Vaya Health ABA therapy coverage in North Carolina
Your Vaya Health coverage, explained
Insurance jargon should never stand between your child and excellent ABA therapy. That's why we handle your Vaya coverage, your authorization, and every step in between, so all you have to focus on is your child.
Does Vaya Health cover ABA therapy?
Yes, and it's built specifically for children like yours
Vaya Health is one of North Carolina's four Behavioral Health and Intellectual/Developmental Disabilities Tailored Plans. Vaya covers ABA for eligible children and young adults under 21 through the federal EPSDT benefit, and integrates physical health, behavioral health, I/DD services, and pharmacy under one plan.
An important update: Vaya Health and Partners Health Management have announced a planned merger into a combined organization called Vaya Partners, expected to take effect October 1, 2026, pending a readiness review. Both organizations have stated that members will not see changes to their benefits or provider relationships during this transition. We'll keep this page updated as more details become available.
What makes Vaya's coverage work
The specifics that matter
No hard hour cap
Coverage is driven by documented medical necessity and your BCBA's clinical recommendation.
Covers 32 counties, based in Asheville
Vaya's Tailored Plan region spans western and central North Carolina, including Buncombe, Henderson, Watauga, and Rockingham counties.
A pending merger worth knowing about
Once the Vaya-Partners merger takes effect, the combined organization will serve 47 counties. We'll help you navigate any transition that affects your family.
How the process works with Vaya Health
From your first call to your first session
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Step 1: Schedule a free consultation
Call (888) 690-0663. We confirm your child is enrolled in Vaya, which is tied to your home county.
- 02
Step 2: We verify your benefits
We confirm your specific coverage and Tailored Plan enrollment status.
- 03
Step 3: We submit your prior authorization
This includes a DSM-5 diagnosis with ICD-10 code F84.0, a referral from your child's primary care provider, a BCBA-led treatment plan, and standardized assessments like the Vineland-3.
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Step 4: Therapy begins
Your child starts sessions at home, at school, or wherever makes the most sense.
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Step 5: We manage your reauthorization
Every 6 months, based on your child's progress.
Why families choose Apex ABA for their Vaya Health coverage
What your coverage is actually paying for
Vaya covers ABA therapy because it works, but it's worth knowing exactly what that coverage buys your child.
Communication
Finding words and the confidence to use them. Asking for help. Expressing needs.
Independence
Doing more, needing less help, one skill at a time.
Social Connection
Playing alongside others, then with them.
Self-Regulation
Fewer meltdowns. More tools to handle the hard moments.
Daily Routines
Mornings, mealtimes, transitions, smoother than you thought possible.
Family Life
Less crisis management. More time to just be family.
How your Vaya Health coverage plays out at Apex
Coverage is one thing. What happens with it is another.
Plenty of families with good coverage still end up on the sidelines. Having Vaya doesn't guarantee that experience is any different, and with a merger ahead, having a provider paying close attention matters even more.
At Apex, you're in the room
Not sidelined while decisions get made about your child. Not waiting to hear about it after the fact.
Small caseloads mean your authorization actually gets used well
We limit our caseloads on purpose. That means your BCBA knows your child, remembers what happened last week, and adjusts before your next reauthorization.
Your Vaya benefits cover therapy where your child actually lives
In-home therapy during real family moments. School-based therapy during class, recess, lunch.
You see exactly how your coverage is being spent
Weekly check-ins with your BCBA. Live coaching during real moments. Written strategies you can use between sessions.
“My son's communication skills have really improved since he started with Apex. He used to have a hard time telling us what he wanted, but now he's able to communicate much better. We're so happy with the progress being made.”
— Ashton C., North Carolina
ABA therapy services covered by Vaya Health
What your coverage can include
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In-Home ABA Therapy — real family moments: breakfast, getting ready, bedtime
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School-Based ABA Therapy — support during class, recess, and lunch
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Parent Training and Support — tools for the hours we're not there
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Daycare ABA Therapy — support at your child's daycare or early learning center
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Weekend ABA Therapy — because progress doesn't take Saturdays off
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Early Intervention ABA Therapy — for toddlers and preschoolers, when it matters most
Vaya Health coverage across North Carolina
Where we serve Vaya families
Vaya's Tailored Plan currently covers 32 counties, including Buncombe, Henderson, Watauga, Chatham, and Rockingham, based out of Asheville.
Don't see your county listed? Reach out anyway, we'll confirm your enrollment and coverage.
Vaya Health ABA therapy FAQs
What you're probably wondering
Yes. Vaya Health and Partners Health Management have announced plans to merge into Vaya Partners, expected to take effect October 1, 2026, pending a readiness review. Both organizations say members won't see immediate changes to benefits or providers.
A DSM-5 autism diagnosis with ICD-10 code F84.0, a referral from your child's primary care provider, a BCBA-led treatment plan, and standardized assessment results.
No hard cap. Hours are based on your BCBA's documented medical necessity and your child's progress.
Roughly every 6 months.
We help you appeal with additional documentation from your child's evaluation and our clinical team.
More coverage options in North Carolina
Don't have Vaya Health?
We also work with Blue Cross Blue Shield, Healthy Blue, Trillium Health Resources, AmeriHealth Caritas, Partners Health Management, WellCare, Optum, Alliance Health, and Carolina Complete Health.
Blue Cross Blue Shield 
Healthy Blue 
Trillium Health Resources 
AmeriHealth Caritas 
Partners Health Management 
WellCare 
Optum 
Alliance Health 
Carolina Complete Health 
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