Medicaid Waiver Programs for Individuals with Autism

Let's face it, no matter which course of treatment you choose to take for helping your loved one with autism, it's going to cost you.  While health insurance may cover services such as occupational and speech therapy, other expenses such as  ABA, respite care, and other expenses incurred are expensive.  One means of finding extra funding is the the Home and Community-Based Services Waivers (HCBS Waivers Section 1915 (c)).  

With medicaid waivers, an individual is allowed more diverse services and supports by "waiving" the need toget those same services in an institution. Medicaid is waived for provisions in order to allow long-term care services to be delivered in community settings. This program is the Medicaid alternative to providing comprehensive long-term services in institutional settings.  Individuals who have been diagnosed with an autism spectrum disorder qualify for this program. 

This program is controlled at the state level. The waiting lists tend to be several years long, so it is best to place your child on this list as soon as you have a diagnosis.  To learn more, check out the website for the Centers for Medicare & Medicaid Services (part of the Department of Health and Human Services). The web address is http://www.cms.hhs.gov/MedicaidStWaivProgDemoPGI/05_HCBSWaivers-Section1915(c).asp .

States may offer a variety of services to consumers under an HCBS waiver program.  These programs may provide a combination of both medical services (i.e. dental services, skilled nursing services) as well as non-medical services (i.e.respite care, case management, environmental modifications). Family members and friends may be providers of waiver services if they meet the specified provider  alifications. Check out the state medicaid agency list at http://64.82.65.67/medicaid/states.html to find contact information for the waiver programs available in your state.  Persons with an autism spectrum disorder are typically placed on similar waiver program waiting lists as individuals with mental retardation or developmental delays.