Insurance Coverage for ABA Therapy Explained

Reviewed by Nechama "Nicole" Fried, MEd, BCBA, LBA

ABA therapy is typically recommended for 10 to 40 hours a week, depending on the child. At the rates North Carolina and Colorado Medicaid pay providers, that adds up to roughly $41,000 to $227,000 a year if therapy runs all 52 weeks.

With coverage, you pay only your share: private plans use deductibles, copays, and coinsurance, and Medicaid charges no copay for children's behavioral health services.



Key Highlights

• Insurance coverage for ABA therapy is common, but the rules depend on your plan type and your state. State autism laws apply to state-regulated plans, and Medicaid covers medically necessary ABA for children under 21.
  
  
• Understanding your specific health insurance plan, whether it's private insurance or Medicaid, is the first step to accessing benefits.
  
  
• An officialautism diagnosis from a licensed practitioner is typically required for insurance to cover ABA therapy costs.
  
  
• State mandates, like those in North Carolina, can allow age limits and annual dollar caps, while Colorado's state-regulated plans have neither.
  
  
• If your claim is denied, you have the right to an appeals process to fight for the necessary services.
  

How Much Does ABA Therapy Cost?

ABA is billed in 15-minute units under CPT codes: 97153 for treatment delivered by a technician (RBT) and 97155 for treatment with protocol modification by a BCBA.

There is no single national price, and commercial insurers negotiate their own rates and don't publish them. The best public benchmarks are the Medicaid fee schedules below, which show what each state pays providers for care.

Hourly rates

North Carolina's 2026 figures reflect the fee schedule restored on January 5, 2026, after a rate cut that began October 1, 2025. Colorado's rates reflect a reduction for dates of service on or after October 1, 2025. Hourly figures are the per-15-minute rate multiplied by four. All rates were retrieved September 30, 2026, and can change. 

Typical weekly hours

The Council of Autism Service Providers (CASP) practice guidelines describe two models: focused ABA, with intensity in a range of about 10 to 25 hours a week for a limited number of goals, and comprehensive ABA, commonly 30 to 40 hours a week for children with delays across several areas.

CASP also describes about one to two hours of BCBA case supervision for every 10 hours of direct treatment. The right number for your child comes from your BCBA's assessment, not a formula. 

What that adds up to

The tables below are Blue Jay calculations from the rates above: technician time at the 97153 rate, plus BCBA time at the 97155 rate, at one hour (low end) to two hours (high end) of BCBA time per 10 direct hours. Annual totals assume 52 weeks with no missed sessions, so real totals are usually lower.

North Carolina Medicaid rates

Colorado Medicaid rates

These figures show what a payer pays providers for care. They are not a price list, and they are not what your family pays.

What You'll Actually Pay With Insurance

Most plans work in this order: you pay the deductible first, then your copay or coinsurance on covered visits, until you reach the plan's out-of-pocket maximum. After that, the plan pays 100% of covered in-network care for the rest of the year.

For 2026, federal rules cap out-of-pocket costs for most non-grandfathered plans at $10,600 for an individual and $21,200 for a family. Premiums and out-of-network costs don't count toward it. Ask your plan how it classifies ABA, because that decides whether the cap applies. 

In North Carolina, state-regulated plans may also set a separate yearly dollar maximum on ABA (see the state table below). That maximum started at $40,000 and has been indexed for inflation since 2017. As an illustration, at the Medicaid-equivalent rates above, $40,000 would cover roughly 8.5 to 9.5 months at 10 hours a week, or roughly 3.4 to 3.8 months at 25 hours a week. Ask your plan whether its ABA benefit maximum is separate from its out-of-pocket maximum. 

Families on Medicaid generally pay no copays. NC Medicaid has no copays for members under 21 or for behavioral health services, and Health First Colorado exempts children 18 and under and behavioral health services from copays. 

How the Rules Differ in North Carolina and Colorado

Navigating the world of insurance can feel overwhelming, especially when you are trying to secure the best care for a loved one with autism spectrum disorder. Understanding your insurance coverage for ABA therapy is a critical step in accessing this life-changing treatment without facing a significant financial burden. This guide is here to demystify the process, providing you with the clear, straightforward information you need to confidently manage your health plan and advocate for your child’s needs.

Introduction to ABA Therapy and Insurance Coverage

Applied Behavior Analysis (ABA) therapy is a leading, evidence-based treatment for individuals with autism. As you explore this option, one of the first questions that likely comes to mind is, "How will we pay for it?" This is where your health insurance plan becomes a vital tool.

Fortunately, insurance coverage for ABA therapy has become much more common. Understanding the basics of what ABA is and how insurance works can empower you to access the support and services your family deserves.

What is ABA Therapy and Who Needs It?

Applied Behavior Analysis, or ABA, is a therapy based on the science of learning and behavior. It is designed to help individuals with autism learn new skills and reduce behaviors that may be challenging. A Board Certified Behavior Analyst (BCBA) designs and oversees a treatment plan tailored to your child’s specific needs.

This therapy is considered one of the most effective treatments for autism spectrum disorder. The primary goal is to promote positive and appropriate behaviors. Many families see significant improvements in key areas, including:

• Enhanced language and communication skills
  
  
• Improved memory, academic performance, and social abilities
  
  

ABA therapy helps individuals with autism by using proven techniques to build skills that will serve them for a lifetime. While insurance coverage can vary, most plans now cover these therapy services for children with a formal autism diagnosis, making this effective treatment more accessible.

Why Understanding Insurance Coverage for ABA Therapy Matters

The cost of ABA therapy is a major concern for families. The cost breakdown above shows what payers in North Carolina and Colorado pay for it and what that means for your family.

Understanding your insurance coverage for ABA therapy services is crucial because it can dramatically reduce these out-of-pocket expenses. With insurance, you are often only responsible for co-pays and deductibles, making consistent therapy affordable. Knowing your benefits allows you to plan effectively and avoid unexpected bills.

Ultimately, navigating your insurance plan empowers you to access medically necessary treatment that can have a profoundly positive impact on your child's development. It removes a major barrier, allowing you and your family to focus on what truly matters: your child's progress and well-being.

Key Insurance Terms in ABA Therapy Policies

When you review your health insurance policies, you will encounter specific language that can be confusing. Learning these key insurance terms will help you better understand yourABA therapy coverageand what you are expected to pay. Having a grasp of this vocabulary is the first step in checking if your insurance plan covers ABA therapy.

Familiarize yourself with these common terms before speaking with your insurance company:

• Deductible: The amount you must pay out-of-pocket for covered services before your insurance provider starts to pay.
  
  
• Co-pay: A fixed amount you pay for a covered health care service, like a therapy session, after you have met your deductible.
  
  
• Co-insurance: The percentage of costs you share with your insurance company for a covered service after your deductible is met.
  
  
• Pre-authorization: A decision by your insurer that a health care service is medically necessary. This approval is often required before you begin ABA therapy.
• Out-of-pocket maximum: the most you pay for covered, in-network care in a plan year. After you reach it, the plan pays 100% of covered in-network care for the rest of the year.

Knowing these terms gives you the confidence to ask the right questions and fully comprehend the information your insurance provider gives you.

How Insurance Coverage for ABA Therapy Works in the United States

Coverage for private insurance is set mainly by state autism laws, which apply to state-regulated (fully insured) plans. Self-funded employer plans are regulated under federal law and are generally not required to follow those state laws, though many cover ABA. Ask your employer's benefits team which type of plan you have.

While this federal law sets a baseline, the specifics of your insurance benefits can still vary based on your private health insurance plan and the state you live in. Below, we'll explore how different types of insurance handle ABA coverage and the role state law plays.

Private Health Insurance Plans and ABA Therapy

If you have a private health insurance plan, your ABA therapy coverage will depend on the type of plan you have. Most families are enrolled in either a fully-insured plan, where an insurance carrier assumes the risk, or a self-funded plan, often provided by larger employers who pay for claims directly. State mandates requiring ABA coverage typically apply to fully-insured plans.

When looking at your private insurance, it is important to review your policy documents carefully. While many insurance companies now offer ABA therapy coverage, the details can differ significantly. Some plans may have more generous benefits than others.

Several major insurance carriers are known for providing ABA therapy coverage, including Blue Cross Blue Shield, UnitedHealthcare, Aetna, and Cigna. However, even with these companies, the level of coverage depends on your specific plan and state regulations. Always verify your benefits directly with your insurance company.

Medicaid and Government Insurance Options for ABA Therapy

Does Medicaid cover ABA therapy? Yes. Medicaid covers medically necessary ABA for eligible children and youth, with prior authorization and a treatment plan. See the state table above for how North Carolina and Colorado each handle it.

In North Carolina, Medicaid coverage is provided through Managed Care Organizations (MCOs), which vary by county. For example, Alliance Health serves counties such as Guilford, while other regions may be covered by plans likeTrillium Health ResourcesorVaya Health. These MCOs handle approvals, provider networks, and care coordination for ABA therapy services.

State Laws and Federal Mandates Affecting ABA Coverage

State autism laws set the details of coverage for state-regulated plans, so your rights depend on where you live. In North Carolina, the mandate started as SB 676 and is codified at G.S. 58-3-192.

The statute says ABA coverage may be subject to a maximum benefit of up to $40,000 a year, indexed for inflation since 2017, and may be limited to individuals 18 or younger. It does not set weekly hour minimums.

North Carolina’s Approach to ABA Therapy Insurance Coverage

Navigating the local landscape means knowing which insurance providers are active in the state and what special considerations exist for families and educators. This knowledge will help you work with your insurance provider to secure the best possible support for your child.

State Mandates for ABA Therapy in North Carolina

In North Carolina, state-regulated plans must cover the screening, diagnosis, and treatment of autism spectrum disorder. The law covers both diagnosis and treatment, and plans may limit ABA coverage to individuals 18 or younger and to an annual maximum.

That maximum was $40,000 in 2016 and is adjusted each year using the Consumer Price Index for the South Region. The Insurance Commissioner posts the new amount by April 1, and it applies to policies purchased or renewed the following calendar year. Ask your insurer for the current figure in writing.

Insurance Providers Known for ABA Coverage in North Carolina

While state law mandates coverage, the experience can still vary between different insurance carriers. In North Carolina, several major insurance providers are known to offer ABA therapy coverage in compliance with state regulations. Working with an ABA provider that is "in-network" with your insurer can make the process smoother and more affordable.

Some of the recognized private health insurance providers that commonly cover ABA therapy in the state include:

• Blue Cross Blue Shield
  
  
• UnitedHealthcare
  
  
• Aetna

Even with these well-known companies, it is essential to remember that coverage details depend on your specific plan. A PPO plan might offer more flexibility in choosing a provider than an HMO plan, which may require referrals and limit you to an in-network behavior analyst. Always verify your ABA therapy coverage directly with your insurance provider to understand co-pays, deductibles, and any pre-authorization requirements.

Special Considerations for Families and Educators in NC

For families and educators in North Carolina's autism community, working together is key to ensuring a child receives the best care. A collaborative approach helps create consistent and effective treatment plans. A qualified behavior analyst or ABA therapist will develop goals that align with the child’s needs both at home and in school.

When seeking therapy services, remember these important points:

• A strong treatment plan is essential. Your ABA provider will create a plan that addresses symptoms of ASD and demonstrates the medical necessity of the therapy, which is crucial for insurance approval.
  
  
• Communication is vital. Keep educators informed about the skills being worked on in therapy so they can be reinforced in the classroom.
  
  
• Know your rights. If your insurance denies coverage for ABA therapy, you have the right to appeal.
  
  

Don't be discouraged by a denial. The appeals process is there for a reason. By gathering supporting documentation and advocating for your child, you can often overturn an initial decision and secure the necessary therapy services.

A Beginner’s Guide to Accessing ABA Therapy Insurance Coverage

Getting started with ABA therapy insurance coverage can feel like a big task, but breaking it down into manageable steps makes it much easier. Your journey begins with gathering the right information and documents. Your health insurance plan will have specific requirements you need to meet before they approve services.

The first step is always to secure a formal autism diagnosis. From there, you will need to provide documentation to your insurance company that proves the therapy is medically necessary. Let's look at what you’ll need.

What You’ll Need to Get Started (Diagnosis, Documentation, etc.)

To begin the process of getting ABA therapy covered by your insurance company, you must first gather some essential documentation. The most critical piece of information is a formal autism diagnosis. Insurers will not cover treatment without one.

A licensed practitioner, such as a developmental pediatrician or psychologist, must conduct the diagnosis. The diagnosis must also meet the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). This formal report is the foundation of your request for coverage.

In addition to the diagnosis, you will likely need:

• A letter of medical necessity from your child’s doctor.
  
  
• A detailed treatment plan from a certified behavior analyst.
  
  
• Your insurance information and a completed pre-authorization request form.
  
  
• Any relevant assessment or evaluation reports.
  
  

Having these documents prepared will streamline your submission to the insurance company and demonstrate a clear need for ABA therapy.

Common Requirements for Insurance Approval of ABA Therapy

Insurance providers have a set of common requirements you must meet to get ABA therapy coverage approved. These criteria are designed to ensure that the treatment is appropriate and medically necessary for your child's condition. Understanding these from the start can help you avoid delays.

The most fundamental requirement is a formal diagnosis of Autism Spectrum Disorder (ASD). Beyond that, your ABA provider will need to demonstrate that the proposed treatment services directly address the symptoms of ASD and are essential for your child’s development. Every specific plan will have its own detailed criteria.

Key requirements often include:

• A recommendation for a specific number of service hours based on a comprehensive assessment.
  
  
• A treatment plan with clear goals, criteria for progress, and a discharge plan.
  
  
• Documentation showing challenging behaviors or deficits in communication and social interaction.
• 
  

Meeting these requirements is crucial for showing your insurance provider that ABA therapy is not just beneficial but a medical necessity for your child.

Step-by-Step Guide to Securing Insurance Coverage for ABA Therapy

Now that you know what you need, let's walk through the process of securing insurance coverage for ABA therapy. Following a clear, step-by-step approach will keep you organized and help you navigate your interactions with your insurance provider effectively. This guide is designed to empower you to move from diagnosis to insurance approval with confidence.

From verifying your plan to submitting documents and tracking your claims, each step is an important part of the puzzle. Let's begin with the very first action you should take.

Step 1: Verify Your Insurance Plan and Covered Benefits

The first and most important step is to thoroughly understand your health insurance plan. Don't assume anything about your coverage. You need to check if your specific plan includes benefits for ABA therapy. The best way to do this is by contacting your insurance provider directly.

When you call, have your insurance card ready. Ask the representative specific questions to get the clarity you need. This is your opportunity to understand what is covered and what your financial responsibility will be.

Be sure to ask about the following:

• Your plan’s coverage for ABA therapy, including any limitations or exclusions.
  
  
• Your deductible, co-pay, co-insurance, and out-of-pocket maximum.
  
  
• Whether you need pre-authorization before starting services.
• 
  

Taking the time to verify your covered benefits upfront will prevent surprises later and ensure you are on the right track from the beginning.

Step 2: Obtain an Autism Diagnosis and Medical Necessity Letter

Once you've confirmed your benefits, the next critical step is to secure the necessary medical documentation. Insurance coverage for ABA therapy is almost always dependent on a formal autism diagnosis. If your child doesn't have one, your pediatrician can refer you to a specialist, like a developmental pediatrician or psychologist, for a comprehensive evaluation.

After the diagnosis is confirmed, you will need to demonstrate the medical necessity of ABA therapy. This is typically done through a letter or detailed report from a doctor or a certified behavior analyst. This document explains why ABA is an essential treatment for your child's specific needs.

To support your case, ensure you have:

• A formal diagnostic report stating your child has Autism Spectrum Disorder.
  
  
• A letter of medical necessity that clearly outlines why ABA therapy is required for your child's development and well-being.

These two documents are the cornerstone of your submission for insurance coverage.

Step 3: Submit Required Documents and Pre-authorization Requests

With your diagnosis and medical necessity letter in hand, you are ready to formally request coverage from your insurance company. This step involves submitting all required documentation for pre-authorization, which is the insurer's approval before the treatment of autism begins. Your ABA provider can often help you with this process.

The pre-authorization request typically includes the treatment plan developed by the certified behavior analyst. This plan should detail the recommended therapy hours, specific goals, and how progress will be measured. A thorough and well-documented plan increases the likelihood of approval.

Ensure your submission package is complete and includes:

• The pre-authorization form from your insurance company.
  
  
• The formal diagnosis report.
  
  
• The letter of medical necessity and the detailed treatment plan.
  
  

Submitting a complete and organized packet makes it easier for the insurance company to review your case and approve the requested services.

Step 4: Communicate with Your Insurance Provider

Maintaining clear and consistent communication with your insurance provider is essential throughout the approval process. After you submit your pre-authorization request, don't just wait. Follow up to confirm they have received your documents and to ask about the expected timeline for a decision.

Keep a detailed record of every conversation you have with your health insurance representative. Note the date, the name of the person you spoke with, and a summary of the conversation. This log can be incredibly helpful if you run into any issues or need to reference a past discussion about your insurance benefits.

When you communicate, remember to:

• Be polite but persistent.
  
  
• Have your policy number and case reference number handy.
  
  

Clear communication ensures you stay informed about the status of your request and can quickly address any questions the insurance company might have regarding your insurance coverage.

Step 5: Track Approvals, Denials, and Ongoing Claims

Once you begin therapy, your work with the insurance company isn't over. You'll need to track approvals, denials, and ongoing claims for ABA therapy services. Most insurance companies approve services for a set period, often six months, after which you'll need to submit a re-authorization request with progress reports.

If your initial request is denied, don't panic. A denial is not the end of the road. It is the beginning of the appeals process. The denial letter from the insurance company must explain the reason for their decision, which will help you prepare your appeal.

Keep organized records of everything, including:

• Authorization letters and their expiration dates.
  
  
• Explanation of Benefits (EOB) statements for each claim.
  
  
• Any denial letters and correspondence related to appeals.
  
  

Staying on top of this paperwork is crucial for ensuring continuous coverage and promptly addressing any issues that may arise with your insurance company.

Medicaid Authorization Steps in North Carolina

For families using Medicaid, there are additional steps required to begin ABA therapy services:

• Obtain a formal autism diagnosis from a qualified provider
• Complete a comprehensive ABA assessment with a BCBA
• Submit a treatment plan and request for authorization through your MCO (such as Alliance Health)
• Receive approval for a set number of therapy hours
• Complete periodic re-authorizations based on progress reports

Working with an experienced provider like Blue Jay ABA can help streamline this process and reduce delays.

Medicaid Authorization Steps in Colorado

Families using Health First Colorado follow these steps:

• Get a formal autism diagnosis and a written order, prescription, or referral for services from an eligible provider
• Complete an assessment with a behavioral therapy provider using a standardized, norm-referenced adaptive behavior tool
• Your provider builds a plan of care with the medically necessary services requested
• Your provider submits a prior authorization request through the state's utilization management vendor, Acentra
• An approved request is valid for up to six months, after which a new request is needed

Troubleshooting Insurance Challenges and Maximizing Coverage

Even with careful preparation, you may face challenges with your insurance coverage for ABA therapy. Denials can be frustrating, but they are often just a roadblock, not a dead end. Understanding how to troubleshoot these issues is key to maximizing your benefits and reducing the financial burden on your family.

You have the right to appeal a decision made by your insurance company. Learning how to navigate the appeals process effectively can make all the difference in securing the coverage your child needs.

What to Do If Your Insurance Denies ABA Therapy Coverage

Receiving a denial for ABA therapy coverage from your insurance company can be disheartening, but it's important to take immediate action. The first thing you should do is carefully read the denial letter. The insurance provider is required to state the specific reason for the denial, which will guide your next steps.

Once you understand the reason, you can begin to gather the necessary information to challenge the decision. This is your opportunity to build a stronger case. Often, a denial is due to missing information or a belief that the therapy is not medically necessary.

Here’s what to do next:

• Contact your insurance provider to clarify the reason for the denial.
  
  
• Work with your ABA provider and doctor to gather additional supporting documents.
  
  
• Formally initiate the appeals process according to the instructions in the denial letter.
  
  

If a Health First Colorado request is denied, your provider can request reconsideration or a peer-to-peer review, and you can submit a written appeal to the Office of Administrative Courts.

A denial is a call to action. By being proactive and organized, you can effectively challenge the decision and advocate for your child’s needs.

Tips for Appealing Insurance Decisions and Overcoming Common Roadblocks

The appeals process is your formal opportunity to ask the insurance provider to reconsider its decision. To make your appeal as strong as possible, you need to be strategic and thorough. A well-crafted appeal can overcome common roadblocks and lead to a successful outcome, ensuring you receive your insurance benefits.

Your appeal should directly address the reason for the denial. If the insurer questioned medical necessity, provide additional evidence from healthcare professionals. This might include new assessments, progress reports, or letters emphasizing the positive impact of ABA therapy on your child.

Follow these tips for a stronger appeal:

• Write a compelling appeal letter that explains why the therapy is essential for your child, referencing state and federal mandates for coverage.
  
  
• Submit all required documentation within the specified timeframe.
  
  
• Follow up regularly on the status of your appeal and be prepared to escalate the case if necessary.
  
  

Persistence is key. Don't give up after the first denial, as many families successfully secure coverage for necessary services through the appeals process.

Conclusion

Understanding insurance coverage for ABA therapy is crucial for families navigating the complexities of autism treatment. By familiarizing yourself with the key aspects such as eligibility, state mandates, and the steps required to secure approval, you can ensure that your loved ones receive the necessary support without unnecessary complications. Remember, every state has its own regulations, and North Carolina has specific provisions that can benefit families. Staying informed empowers you to tackle challenges and maximize yourcoverage options. Your journey towards securing the right resources starts now!

AtBlue Jay ABA,  our experts guide families through eligibility, state mandates, and approval steps to ensure children receive the support they deserve. In addition, navigating insurance coverage forABA therapy in North Carolinacan feel overwhelming, but you don’t have to do it alone. 

Want to know what ABA would cost for your child? Request a free benefits check and we'll review your coverage with you.

Frequently Asked Questions

• Does insurance typically cover ABA therapy for children with autism?

  Coverage depends on your plan type and your state. State autism laws apply to state-regulated plans, self-funded employer plans may not be bound by them, and Medicaid covers medically necessary ABA for eligible children.

• How do I check if my health insurance plan includes coverage for ABA therapy?

  The best way to check for ABA therapy coverage is to call your insurance company directly. Review your plan's Summary of Benefits and Coverage document, or log in to your insurer's online portal. Ask your insurance provider specifically about benefits for autism services and pre-authorization requirements.

• Are there differences in ABA therapy insurance coverage depending on which state you live in?

  Yes, there are significant differences. While a federal law sets a baseline, state mandates determine specific regulations like age limits, annual spending caps, and the number of covered hours for ABA therapy services. It's crucial to understand the laws in the state where you live to know your rights.

• What are the most common documents needed for ABA therapy insurance approval?

  The most common documents are a formal autism diagnosis from a licensed practitioner, a letter of medical necessity from a doctor, and a detailed treatment plan from a certified behavior analyst. Your insurance company will also require a pre-authorization request form before approving ABA therapy.

• Does Blue Cross Blue Shield cover ABA therapy in North Carolina?

  Coverage depends on your specific plan. Plans that are state-regulated fall under G.S. 58-3-192, which allows an annual ABA maximum (indexed from $40,000). Self-funded plans may differ. Ask your plan for its ABA benefit details in writing.

• What if I have no insurance?

  Start by checking Medicaid. The best way to find out whether you're eligible for NC Medicaid is to apply. Children in North Carolina under 21 and Health First Colorado members 20 and younger can receive ABA through Medicaid if they qualify and meet medical necessity criteria. In Colorado, Child Health Plan Plus (CHP+) does not cover ABA, so ask about Health First Colorado first. If your child doesn't qualify for any coverage, you are responsible for the full cost of care, and the tables above show what public payers pay per hour and per year. Providers set their own self-pay terms, so ask any provider directly.

SOURCES:

- North Carolina G.S. 58-3-192. https://www.ncleg.gov/EnactedLegislation/Statutes/HTML/BySection/Chapter_58/GS_58-3-192.html
- NC Medicaid, Clinical Coverage Policy 8F: Research-Based Behavioral Health Treatment. https://medicaid.ncdhhs.gov/8f-research-based-behavioral-health-treatment-rb-bht-autism-spectrum-disorder-asd
- NC Medicaid Copays (page last modified April 24, 2026). https://medicaid.ncdhhs.gov/about-nc-medicaid/nc-medicaid-copays
- NC Medicaid fee schedule, 97153 and 97155 (schedule posted January 5, 2026).
- BACB, Clarifications regarding the CASP ASD practice guidelines (2nd ed.). https://assets.bacb.com/wp-content/uploads/2020/05/Clarifications_ASD_Practice_Guidelines_2nd_ed.pdf
- HealthCare.gov, out-of-pocket maximum/limit. https://www.healthcare.gov/glossary/out-of-pocket-maximum-limit/

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