Find Your Program is an advertising-supported site. Featured or trusted partner programs and all school search, finder, or match results are for schools that compensate us. This compensation does not influence our school rankings, resource guides, or other editorially-independent information published on this site.

Does Autism Qualify for Medicaid?

Currently, approximately one percent of the population falls on the spectrum of autism disorders. This might not seem like a lot but there are many people in each city that are in need of some sort of assistance because of their autism-related issues. This could be monetary assistance, therapy, education, resources, etc. Recently, our federal government made the decision to provide medical care and assistance through a number of Medicaid programs. Depending on the state, there are different resources available. These services are provided to children that have been diagnosed with autism from birth up to the age of twenty-one. Diagnostic services are available as well as ongoing treatment.

Another excellent resource: 40 Best Online ABA Graduate Certificate Online Programs

What Exactly Is Covered By Medicaid?

Currently, Congress has decided what benefits are going to be provided to patients with autism by way of Medicaid assistance. The federal government does not provide very specific details on this coverage though. Basically, each state will need to determine what type of services are medically necessary for people with autism and then that will be covered. For the most part, this is an umbrella term and anything pertaining to autism will be included. Autism Speaks is a nationwide organization that aims to educate families, patients and the public on autism. Their organization has dedicated much of their time to monitoring all states in the U.S. and ensuring that nothing is being ignored. Medical professionals also have a say in what types of assistance their patients will be eligible to receive based on their diagnosis and their current state of health. For more information, you can visit Autism Speaks.

Why Is There A Delay In Coverage?

The decision to provide autism assistance by way of Medicaid coverage is a relatively new decision. Because of this, many states are going to need time to incorporate all of these new guidelines into their current Medicaid plans. Certain plans may need to be under further review and many policy changes will need to take place in order to get all of this coverage ready. There is not currently a set date in place that requires all states to have their policies in place but the work is being done and there shouldn’t be any delays to set everything back in an inconvenient manner.

How Does This Affect The Medicaid Budget?

As with many aspects of a state’s budget, autism coverage has often been overestimated. While a state might predict they need to set aside $10 million each year for autism patients, the expenses may only add up to $3 million each year. While this does affect a Medicaid budget to some degree, it will not be quite as devastating to a budget as many politicians assume it will be. Currently, the overall cost is shared by the federal government as well as each state.

Medicaid is the main source of health coverage for approximately one-third of all American children that have been diagnosed with autism. Even people with autism who have their own primary health insurance are using Medicaid coverage to access other services that can help them. Luckily, the need for Medicaid assistance for people with autism has been recognized and the changes are being put into effect to help people. If you are interested in finding out more about qualifying for coverage, you can contact your state’s Medicaid health agency.