Financial Help for Autism

Supporting kids and teens with autism can be tough on the wallet. Luckily, there are ways to ease the financial strain. Let's break down the options: financial support, scholarships and grants, and government programs.

Financial Support Overview

There are many programs out there to help families dealing with autism. Some are open to everyone who meets certain criteria, while others are specifically for those with disabilities. These programs aim to provide financial help and resources to make life a bit easier.

Scholarships and Grants

Scholarships and grants can help cover the costs of education for those with autism. There are many out there specifically for students with disabilities. These funds can help pay for tuition, books, therapies, and other school-related expenses.

Take the NEADS 2024 Summer Financial Assistance Program, for example. This program, run by the National Educational Association of Disabled Students (NEADS), helps cover the extra costs that students with disabilities face in higher education.

Government Programs and Benefits

Government programs can offer significant financial support for those with autism. One such program is Supplemental Security Income (SSI), which provides monthly payments to people who are 65 or older, blind, or disabled. Those with autism may qualify for SSI, which can help cover their needs.

It's important to understand the eligibility criteria and application processes for these programs, as they can vary by location and situation. Local government agencies and autism advocacy organizations can provide valuable information and assistance.

By exploring scholarships, grants, and government programs, families can find financial help to ease the burden of autism. Stay informed about available resources and reach out to relevant organizations for guidance and support.

Health Insurance Coverage

Health insurance is a big part of getting financial help for autism. Knowing the ins and outs of your health insurance, and the specific benefits for autism-related services, is crucial. Let's look at the different aspects of health insurance coverage for autism.

Understanding Health Insurance

Health insurance is a key resource for families seeking financial help for autism. Coverage varies by state and insurance plan, but most states require insurers to cover the diagnosis and treatment of autism spectrum disorders. However, some argue that the responsibility for care lies with parents and schools, while others worry about potential increases in insurance premiums.

To find out what your insurance covers, review your policy or contact your provider directly. Knowing the terms, limitations, and requirements of your plan will help you navigate the process of seeking financial help for autism-related services.

Autism-Specific Health Benefits

Autism-specific health benefits are designed to support those with autism in accessing necessary services and treatments. These benefits often include coverage for:

Coverage for these services may have limitations, such as visit frequency or maximum dollar amounts. Review your insurance policy or contact your provider to understand the specifics of your coverage.

Medicaid Waiver Programs

Medicaid waiver programs offer another way to get financial help for those with autism. These programs help individuals who may not qualify for traditional Medicaid but still need support for their healthcare needs. Medicaid waivers offer services like therapies, specialized equipment, and respite care.

Eligibility and available services under Medicaid waiver programs vary by state. Research the specific programs in your state and understand the application process. Contact your local Medicaid office or visit their website for more information.

Navigating health insurance coverage for autism can be tricky, but understanding the available benefits and programs can provide families with the financial help they need. Be proactive in exploring your insurance policy details to ensure your child has access to necessary treatments and services. Consult with healthcare professionals, insurance providers, and advocacy organizations to maximize the financial resources available to support your child with autism.

Non-Profit Organizations and Foundations

Non-profit organizations and foundations can be valuable resources for financial help with autism-related expenses. These organizations offer various programs and grants specifically designed to support individuals with autism and their families. Here are three key areas where non-profits provide assistance:

Autism-Specific Assistance Programs

Several non-profits offer autism-specific assistance programs to help families cover a wide range of needs. One such organization is Autism Care Today, which offers the Quarterly Assistance Program. This program provides direct financial help by paying service providers for services families might not otherwise afford. Support areas include ABA therapy, speech and occupational therapy, assistive technologies, safety equipment, social skills groups, special needs summer camps, and more.

Equipment and Device Grants

Specialized equipment and devices can greatly improve the daily lives of those with autism. Non-profits like Ability Found and the National Autism Association offer grants for equipment and devices. Ability Found provides items like adapted pediatric strollers, pediatric toileting equipment, and communication devices to promote independence and productivity. The National Autism Association's Give A Voice program focuses on providing communication devices to non-verbal or minimally verbal individuals with autism, reducing communication challenges that increase their risk of injury or harm.

Financial Aid for Treatments and Services

Non-profits also offer financial aid to help families access essential treatments and services for those with autism. The Oracle Health Foundation's pediatric grants, for example, help connect children to necessary medical care when financial constraints and insurance limitations make it challenging to cover their medical expenses. These grants serve as a lifeline for families to ensure their children receive vital healthcare.

Exploring non-profits and foundations that specialize in assisting those with autism can open up avenues for financial support. These organizations offer various programs and grants that cater specifically to the needs of individuals with autism and their families. By taking advantage of these resources, families can ease some of the financial burdens associated with autism and access the necessary support to improve the lives of their loved ones.

State-Specific Coverage

Financial help for autism varies by state. Let's look at the coverage and requirements for three specific states: Alabama, Alaska, and Arizona.

Alabama

In Alabama, health benefit plans must cover the screening, diagnosis, and treatment of autism spectrum disorders for insured children 18 and under. The coverage should not be subject to dollar limits, deductibles, or coinsurance provisions that are less favorable than those for general illness coverage.

Coverage for behavioral therapy is included, but there are maximum benefit limits based on the child's age. For children 0-9 years old, the maximum benefit per year is $40,000. For children 10-13 years old, the maximum benefit is $30,000 per year. For children 14-18 years old, the maximum benefit is $20,000 per year.

Alaska

In Alaska, health care insurers must cover the costs of diagnosing and treating autism spectrum disorders, including ABA therapy. Coverage is mandated for individuals under 21 years old, and the number of visits to an autism service provider for treatment may not be limited. Coverage is subject to copayment, deductible, and coinsurance provisions included in the health insurance policy to the same extent as other covered health care services.

Arizona

In Arizona, health insurers must cover the diagnosis and treatment of autism spectrum disorders. Insurers cannot exclude or deny coverage based solely on the autism diagnosis. Additionally, dollar limits, deductibles, and coinsurance cannot be imposed solely because of the autism diagnosis.

Coverage for medically necessary behavioral therapy services is included, subject to maximum benefit limits. The maximum benefit per year for an eligible person up to age 9 is $50,000, and for an eligible person between ages 9 and 16 years, the maximum benefit per year is $25,000.

Check with specific insurance providers and review the details of the coverage available in your state. This information can help you navigate the financial help options and ensure your child receives the necessary support and treatments for their autism spectrum disorder.

Planning for the Future

Planning for the financial future of a child or teen with autism is crucial. There are several strategies and resources available to help navigate the financial aspect of autism. Let's explore financial planning for autism, special needs trusts, and ABLE accounts.

Financial Planning for Autism

Financial planning for autism involves creating a long-term strategy to ensure the financial well-being of the individual with autism. Consider factors like medical expenses, therapy costs, educational needs, and future living arrangements. Developing a comprehensive plan can help provide the necessary support and resources throughout their life.

Autism Speaks offers a Special Needs Financial Planning Tool Kit that provides valuable information and insights from experts and personal stories to assist parents in mapping out the financial future of their child with autism. This toolkit can help parents understand the various financial considerations and options available.

Special Needs Trusts

A special needs trust, also known as a supplemental needs trust, is a legal arrangement designed to protect the assets of an individual with disabilities while allowing them to maintain eligibility for government benefits. These trusts are specifically tailored to meet the unique needs of individuals with special needs, such as autism.

The purpose of a special needs trust is to provide financial support that can supplement government benefits, not replace them. It can cover a wide range of expenses, including medical care, therapies, education, housing, and recreational activities. By establishing a special needs trust, parents can ensure that their child with autism continues to receive the necessary support without jeopardizing their eligibility for government assistance.

ABLE Accounts

The Achieving a Better Life Experience (ABLE) Act of 2014 introduced ABLE accounts as a savings option for families of individuals with disabilities, including autism. ABLE accounts offer tax-advantaged savings without affecting eligibility for benefits like Medicaid and SSI.

These accounts allow individuals with disabilities to save money for qualified expenses, such as education, housing, transportation, and healthcare. Contributions to ABLE accounts are made on an after-tax basis, and the funds can grow tax-free when used for qualified disability expenses. ABLE accounts provide individuals with autism and their families an opportunity to save for the future while maintaining eligibility for important government benefits.

When considering financial planning for autism, consult with a financial advisor or an attorney specializing in special needs planning. They can provide guidance and help develop a personalized plan that takes into account the unique needs and goals of your family.

By undertaking proper financial planning, utilizing special needs trusts, and considering the benefits of ABLE accounts, parents can take proactive steps to secure the financial future of their child with autism.

References

[1]: https://www.autismspeaks.org/financial-autism-support

[2]: https://disabilityawards.ca/

[3]: https://www.ncsl.org/health/autism-and-insurance-coverage-state-laws

[4]: https://www.autismspeaks.org/autism-grants-families