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We know it can be challenging to identify and understand various funding sources. Depending
on where you live, you may have access to funding for autism treatment through employer-
based insurance, your State Marketplace (commonly called Obamacare), Medicaid, and/or a
state-funded entity, such as California’s regional centers. CARD’s team of funding experts is
available to help you understand your options.
With the implementation of the Affordable Care Act, newly recognized benefits under Medicaid Early Periodic Screening, Diagnosis, and Treatment (EPSDT) for individuals under 21, and more and more states requiring autism coverage in their insurance plans, access to autism treatment coverage continues to grow. If you have questions about whether you can access funding for autism treatment through Medicaid or insurance, please contact us.
If you live in one of those 29 states, you may be able to purchase an individual policy that includes coverage for autism treatment through your State Marketplace or at HealthCare.gov (if your state did not set up its own marketplace). You may also qualify for tax credits and federal subsidies to help you pay for that insurance.
On July 7, 2014, the Centers for Medicaid & Medicare Services issued an informational bulletin that clarifies that state Medicaid agencies must provide autism treatment coverage under their EPSDT benefits. The criteria to qualify for Medicaid can differ from state to state, so ask your local Medicaid office or advocacy organization how your child can qualify, or contact CARD to complete an eligibility determination.PDF: Medicaid Autism Benefits
Even in states with mandates, not all insurance plans are required to provide coverage for autism treatment. This is most often true for self-funded plans. An increasing number of these self-funded plans have voluntarily added ABA therapy benefits to their healthcare plans. Check with your company’s human resources department to see if your plan includes autism treatment as a benefit. If not, ask if it can be added. Many employers are very responsive to these requests, as the actual cost of adding autism treatment to an employer plan is minimal. Autism Speaks offers a great toolkit to help families secure autism coverage in their employer plan.PDF: Autism Speaks ERISA Toolkit
If you live in California and are 21 or older, you may have access to treatment through one of California’s 21 regional centers. Regional centers contract with California’s Department of Developmental Services to provide or coordinate services and supports for the developmentally disabled throughout their lifetime. CARD is vendored with multiple regional centers to provide services for people of all ages. To find contact information for your local regional center, consult the DDS regional center directory.DDS Regional Center Directory Get Started with Admissions
JULIE WILL WRITE In facilisis scelerisque dui vel dignissim. Sed nunc orci, ultricies congue vehicula quis, facilisis a orci. In aliquet facilisis condimentum. Donec at orci orci, a dictum justo. Sed a nunc non lectus fringilla suscipit. Vivamus pretium sapien sit amet mauris aliquet eleifend vel vitae arcu. Fusce pharetra dignissim nisl egestas pretium.PDF: What is public policy