Raising a child with special needs can be physically, emotionally, and financially draining. Insurance coverage may barely make a dent in the costs for specialized medical care, childcare, recreational needs, and other care an autistic child or children with other special needs may require in their lifetime.
As coverage expands for autistic children throughout the United States and autism mandates are being passed, it benefits some, but not all, families. There are still many loopholes in coverage and self-funded plans have discretion whether they will cover members for treatment related to autism. For those that do have coverage, many have significant out-of-pocket costs for deductibles, co-insurance, and out-of-pocket maximums that may range between $5,000 and $10,000 annually. Many services that are beneficial to autistic children are not considered medical and are not covered by health insurance, which leaves parents/guardians with more expenses to cover.
As parents seek coverage for ABA therapy or other medical services for their children, many have turned to the marketplace for commercial health plans that offer coverage for autism; however, these plans may be very costly and unavailable to some. Other parents have turned to state Medicaid programs or other government funding programs for autism, which can vary significantly from state to state. It is beneficial for parents/guardians to seek out all coverage options for their child as costs continue to mount.
Tips for providers to help families with financial burdens
- Become a Medicaid provider in your area and encourage your patients to apply for Medicaid.
- Provide detailed explanations of financial obligations — knowing up front makes it easier for families to plan accordingly.
- Encourage the use of Health Savings Accounts or Flexible Spending Accounts, if possible.
- Offer payment plans for patient responsibility.
- Develop a financial hardship policy.
- Keep abreast of community resources and refer as much as possible.
Grants may be available for children for their treatment, specialized equipment, or other needs.
What funding is available for autism?
Families can explore several funding options to support their autistic child’s therapy requirements. Government programs at both the federal and state levels offer financial assistance and services. For instance, Medicaid and the Children’s Health Insurance Program (CHIP) provide coverage for necessary medical and therapeutic services. Some states also have specific waivers and programs dedicated to individuals with developmental disabilities, which can include funding for autism-related services.
Private insurance can also be a significant source of funding. Recent legislative changes have mandated that insurance companies cover certain autism therapies, such as ABA. It’s essential for families to check with their insurance providers to understand the extent of their coverage and any out-of-pocket expenses that may be required.
In addition to grants and scholarships, crowdfunding has emerged as a modern avenue for raising funds. Platforms like GoFundMe allow families to share their stories and seek financial support from friends, family, and the broader community. While this approach can yield substantial support, it requires effective storytelling and outreach efforts.
Lastly, non-profit organizations and local community groups often provide supplemental funding or direct assistance. Organizations and local autism support groups may offer small grants, respite care, or even community-based services that can help alleviate financial burdens. By combining these various funding sources, families can create a more comprehensive support system for autistic individuals.
Refer to these organizations for lists of available options of autism funding for parents:
How to apply for autism funding
To apply for autism funding, families can explore a variety of grants designed to support the needs of autistic children. The application process typically involves several steps:
- Research potential grants: Begin by identifying grants that align with your specific needs and eligibility criteria.
- Gather necessary documentation: Most grant applications require personal information, medical diagnoses, and financial details. Having these documents prepared can streamline the application process.
- Complete the application: Carefully fill out each grant application, ensuring that all required fields are completed accurately. Some grants may ask for additional essays or statements that explain your family’s unique situation and needs.
- Submit and follow up: After submitting the application, keep track of deadlines and any follow-up inquiries from the grant organization. Persistence and attentiveness can enhance your chances of receiving funding.
Consult Missing Piece to learn more about autism funding grants
If you find billing and funding overwhelming, Missing Piece Billing and Consulting can help. Contact us to schedule a free evaluation and see how we can assist.