Individual & family health · Houston, Texas · Est. 1996
Will this plan take your child's ABA clinic?
Tell us the clinic, the doctors and the prescriptions your family already depends on. A Texas-licensed advisor checks them against every 2026 individual marketplace plan available where you live, then tells you what ABA therapy would actually cost you under each one — before you enroll in anything.
Step 1 of 8
Who should we get back to?
We take this first so that if anything interrupts you, an advisor can still call and finish it with you on the phone.
Where do you live, and who needs coverage?
Marketplace plans and prices are set county by county, so the ZIP code decides which plans you can even see.
Tell us about your child
This decides more than anything else on this page. Two rules in Texas turn on it, and both of them are easy to miss.
Which ABA clinic do you want to keep?
This is the question the marketplace website cannot answer well and the one we care most about. Name the clinic even if you are only on their waiting list.
Any other doctors you want to keep?
Pediatrician, developmental pediatrician, psychiatrist, speech or occupational therapy — anyone you would rather not have to change.
Any prescriptions?
Just the names are enough. We check each one against the plan's own drug list, because a plan that takes your clinic but drops a medication is not a win.
Last one — household income
We need this because of two rules that decide far more than the sticker price. Below certain income levels a child with a disability may qualify for coverage that pays for ABA with no annual cap at all — and above one line, the 2026 subsidy stops entirely.
We do not verify or store income documents. This is a band, not a number on a form.
Anything else we should know?
A denied claim, an authorization that ran out, a clinic that just went out of network — whatever made you come to this page.
Got it. An advisor is on this.
A Texas-licensed advisor from our Houston office reviews your answers against the 2026 plans available in your county and comes back to you — the same business day if you sent this during business hours.
What happens next
- We look up each clinic and doctor you named in the federal Marketplace's own network data, plan by plan.
- We check every prescription against each plan's drug list.
- We work out what ABA therapy would actually cost you under each plan — and whether a public program would cost you less than any of them.
- You get a plain answer, in English or Spanish, with the assumptions written down so you can check them.
What this does and doesn't tell you
- This is an estimate built from public federal Marketplace data and published public-payer rate schedules. What insurers actually pay ABA providers is set by private contract and is not public, so any cost we show you is a range between two documented public figures, never a single number dressed up as certainty.
- Texas's autism mandate — Insurance Code §1355.015 — is written into a subchapter that applies only to group health benefit plans, so it is not the law that makes your individual marketplace plan cover ABA. Two other things do. Federally, the Essential Health Benefits rules put autism services inside the benefits every marketplace plan must include. And under Texas law, Insurance Code Chapter 1355, Subchapter F (§1355.252–.254) applies expressly to individual policies and requires behavioral-health benefits to be no more restricted than medical ones — enforced by the Texas Department of Insurance, which regulates your plan and runs a parity complaint portal you can use. So: real coverage, real state protection, a different statute than the one people usually cite. We would rather you have the right citation than a confident wrong one.
- Network lists go stale. When we say a clinic is in network we are reading the insurer's own submitted data, and insurers sometimes submit nothing at all — which is not the same as saying no. Anything unclear gets a phone call to the carrier before you enroll, not a shrug.
- Nothing here is a determination of eligibility for any program, and nothing here is a guarantee of coverage. It is preparation for a conversation with a licensed human being.