State guide

North Carolina

Programs, dollars, and people that serve autism families in North Carolina. Federal protections always apply on top of what you see here.

North Carolina overview

North Carolina's Medicaid Innovations waiver is administered through DHHS — apply through your Local Management Entity/Managed Care Organization (LME/MCO). NC has made progress on waiver waitlists but they remain significant. The Autism Society of North Carolina (ASNC) is one of the strongest state-level autism organizations in the country — offering case management, residential services, and family support statewide. The Exceptional Children Assistance Center (ECAC) is NC's PTI center. The Carolina Institute for Developmental Disabilities at UNC Chapel Hill is a major research and clinical resource.

Verify program names, URLs, and eligibility on official .gov sites — these change.

⏰ Act now — Medicaid waiver waitlist

NC Innovations Waiver (DHHS / LME-MCOs)

Typical wait: varies by LME-MCO — typically 2–10 years

Apply through your county's LME-MCO the day of diagnosis — North Carolina's waiver is managed locally by regional Managed Care Organizations.

Find your county's LME-MCO through NCDHHS. Waitlist length varies significantly by region.

Apply or learn more →

Statewide resources

These four programs exist in every state and are the fastest entry points for most families.

Insurance Coverage

Whether private insurance must cover ABA therapy in North Carolina.

North Carolina requires insurance to cover ABA therapy

NCGS §58-51-57 · effective 2015

Through age 18No dollar capDiagnosis required

Covers ABA through age 18 with no dollar cap. Requires autism diagnosis and treatment by a licensed BCBA. Self-funded employer plans (ERISA) are exempt — verify your plan type with HR before filing an appeal.

Self-funded employer plans (ERISA) are typically exempt — ask your HR department which type of plan you have.

Medicaid Waiver

Home and community-based services (HCBS) for autism families in North Carolina.

Innovations Medicaid Waiver

North Carolina Division of Mental Health, Developmental Disabilities and Substance Use Services (DMHDDSUS)

Currently closed

Typical wait time

7-10+ years in many counties

Coverage highlights

  • ✓Respite
  • ✓Supported Living
  • ✗Therapy
  • ✓Employment Supports

North Carolina's Innovations Waiver has one of the longest waitlists in the country — some families wait 10+ years, especially in populous counties. Families must register with their Local Management Entity/Managed Care Organization (LME/MCO) immediately. NC also has a Traumatic Brain Injury (TBI) waiver and CAP/C waiver for children with medical complexity.

How to apply

Apply online →919-733-3654

Medicaid Managed Care

How Medicaid pays for ABA therapy in North Carolina.

NC Medicaid Managed Care (Tailored Plans)

Covers ABA through under 21

How to find your plan

Visit ncdhhs.gov/medicaid or call 1-888-245-0179. NC Medicaid uses Behavioral Health I/DD Tailored Plans — your plan depends on your county of residence.

Major plans in this state

  • Alliance Health (Tailored Plan)
  • Partners Health Management (Tailored Plan)
  • Trillium Health Resources (Tailored Plan)
  • Cardinal Innovations Healthcare (Tailored Plan)

North Carolina uses regional Behavioral Health I/DD Tailored Plans for Medicaid members who need behavioral health or intellectual/developmental disability services, including autism. ABA therapy is covered for children under 21. Standard physical health is managed through separate standard plans. Prior authorization is required for ABA services.

⚠️ Prior authorization is required before starting ABA services.

By county

100 counties