Can You Get Financial Help for Autism?

Understanding Autism and Financial Support

Navigating the world of autism can be a daunting task, especially when it comes to understanding and accessing the financial support available. This section provides a brief overview of autism and explores the financial impact it can have on families.

Autism: A Brief Overview

Autism, or Autism Spectrum Disorder (ASD), is a developmental condition that affects social interactions, communication, and behavior. The symptoms and severity of autism can vary greatly from one individual to another, and it is typically diagnosed in early childhood. Individuals with autism often require specialized care and support, which can lead to significant financial considerations for their families.

Various private and non-profit organizations offer research funding, support, and information for individuals with autism or other developmental disabilities, as well as their families [1].

The Financial Impact of Autism

Raising a child with autism can indeed present financial challenges. Estimates suggest that parents of disabled children need 17.8% more income per year to care for their child, and it can cost up to $2.4 million to raise a child with a disability over a lifetime. These costs often last into adulthood [2].

Personal assistance and healthcare are the most expensive parts of caring for a disabled child, with medical equipment, hospitalizations, and doctor visits also adding up. Medical costs overall are paid out-of-pocket at twice the rate as those without a disability [2].

These statistics underline the importance of understanding and accessing the financial support available for families affected by autism. In the following sections, we will explore governmental assistance, state-specific programs, private and non-profit organizations' support, health insurance considerations, and financial planning for autism.

Governmental Assistance for Autism

Seeking financial help for the care and support of loved ones with autism is a common concern among families. Numerous government programs are available, providing necessary funding to ensure individuals with autism can access the services, treatment, and support they require.

Supplemental Security Income (SSI)

Supplemental Security Income (SSI) is a federal program providing financial assistance to low-income families with children who meet the Social Security Administration's definition of disabled. This includes children with autism, as long as they display "marked and severe functional limitations" [2].

The amount of aid provided through SSI varies depending on the family's income and the state in which they reside. It can serve as a helpful source of assistance for families managing the financial implications of autism.

Social Security Disability Insurance (SSDI)

Social Security Disability Insurance (SSDI) is another government program that may provide financial assistance for families with a member diagnosed with autism. SSDI benefits are based on the disabled individual's past work history and contributions to the Social Security trust fund through payroll taxes.

However, it's important to note that SSDI is typically applicable to adults who have developed a disability preventing them from working. As such, it might not be as relevant to families seeking support for a child with autism, but may be an option when the child grows older and has a work history.

Medicaid and Autism

Medicaid is a federal and state program that provides health coverage to people with disabilities, including children with autism, who fall below a certain income level. To qualify, the child must require a certain level of care, and the income requirements can vary by state.

Medicaid can cover a wide range of services, including medical appointments, hospital services, prescriptions, and medical equipment. This can significantly reduce the financial burden of healthcare costs associated with autism.

Navigating governmental assistance programs can be complex, but they offer valuable resources for families managing the financial implications of autism. Understanding these programs and how they might apply to your specific situation is an important step toward securing the necessary funding for your loved one's care and support.

State-Specific Financial Assistance Programs

Each state in the U.S. offers distinct financial assistance programs to aid families dealing with autism. These programs aim to alleviate some of the financial pressures that come with managing autism. Here, we delve into three key programs: Achieving a Better Life Experience (ABLE) Act, Community Action Agencies, and Special Services at Home Program (SSAH).

Achieving a Better Life Experience (ABLE) Act

The Achieving a Better Life Experience (ABLE) Act of 2014 established ABLE accounts for families of individuals with disabilities. These accounts provide a savings option that does not affect eligibility for public benefits like Medicaid and Supplemental Security Income (SSI). Operated at the state level, ABLE accounts offer tax-advantaged savings for long-term expenses. This offers a significant financial cushion for the future needs of individuals with autism.

Community Action Agencies

Community Action Agencies play a crucial role in providing support services to individuals with autism. Especially relevant are Medicaid Waivers, known as 1915(c) Home and Community Based Services. These waivers are designed to provide support services and care to individuals with developmental disabilities. They aim to enable these individuals to stay at home or in the community rather than in an institution. The benefits provided by these waiver programs vary by state and may include coverage for medical treatments, respite care, transportation, in-home support, and more.

Special Services at Home Program (SSAH)

While the Special Services at Home Program (SSAH) is specific to Ontario, it provides an excellent model for state-specific assistance. SSAH offers financial assistance to families of children with physical or developmental disabilities. Notably, eligibility is not based on family income. If approved, funds can be used to hire a support worker or pay for respite services. This program can significantly ease the financial burden of families dealing with autism.

In conclusion, state-specific financial assistance programs play a vital role in supporting families dealing with autism. By exploring these and other programs available in their state, families can find significant financial help for autism, ensuring they have the necessary resources to provide the best care possible for their loved ones.

Private and Non-profit Organizations' Support for Autism

In addition to governmental assistance, there are several private and non-profit organizations offering financial support for families affected by autism. These organizations provide a range of services, from scholarships for therapeutic programs to assistance with therapy costs. Here, we'll explore three organizations that aid families in managing the financial aspects of autism: The Autism Spectrum Disorder Foundation (ASDF), Autism Care Today's Quarterly Assistance Program, and the National Autism Association (NAA).

Autism Spectrum Disorder Foundation (ASDF)

The Autism Spectrum Disorder Foundation (ASDF) is committed to empowering families with autistic children. One of their key offerings is the Summer Scholarship Program. This initiative provides financial support for social skills camps, swimming programs, and equine assisted services for autistic children. These programs are designed to enhance their communication skills and self-confidence, contributing positively to their overall development. For more details on the scholarships and eligibility criteria, visit the ASDF's official website.

Autism Care Today's Quarterly Assistance Program

Autism Care Today's Quarterly Assistance Program is a crucial resource for families in need of financial aid for their autistic child's services. This program directly pays a child's service provider for various services including Applied Behavior Analysis Therapy, speech and occupational therapy, bio-medical testing, supplements, and assistive technologies like iPads, communication apps, and safety equipment. This service ensures that families can access necessary therapeutic and support services without worrying about the financial burden.

National Autism Association (NAA)

The National Autism Association (NAA) offers a unique program known as the Give A Voice program. This program is designed to offer communication devices to non-verbal or minimally verbal individuals with autism. The aim is to mitigate the risk of injury or harm due to communication challenges, ensuring the safety and wellbeing of autistic individuals. The NAA is dedicated to providing these aids to families who may not otherwise have the financial means to afford them [5].

In conclusion, these private and non-profit organizations play an essential role in providing financial support for families affected by autism. Their programs are designed to reduce the financial burden and ensure that children with autism have access to the necessary services and tools for their development and wellbeing. It's important for families to reach out to these organizations and explore the assistance options available to them.

Health Insurance and Autism

In the journey to secure financial help for autism, understanding your health insurance plan and discovering other savings opportunities, such as Flexible Spending Accounts (FSAs) and Health Savings Accounts (HSAs), can be instrumental.

Understanding Your Health Insurance Plan

Most private insurance policies for autism treatments have co-insurance requirements that may include deductibles, co-pays, and other forms of cost sharing. These can range from minimal amounts to thousands of dollars, potentially creating financial hardships for families [6].

For individuals with autism who require treatments resulting in multiple co-payments per day or week, they may likely reach the Out-of-Pocket Maximum (OOP) for their plan well before the end of the plan year, relieving them from further co-insurance obligations.

Several organizations like the United Healthcare Children’s Foundation provide medical grants to help cover child health care services. These grants, up to $5,000, can help pay for therapy, prescriptions, and medical equipment for children 16 years of age or younger who meet economic guidelines and are covered by a commercial health insurance plan.

Flexible Spending Accounts (FSAs) and Health Savings Accounts (HSAs)

Flexible Spending Accounts (FSAs) and Health Savings Accounts (HSAs) can offer relief to families seeking financial assistance for autism. They allow individuals to set aside money for various health care expenses, providing a source of savings for many families while avoiding paying income taxes on the amounts saved.

In addition to FSAs and HSAs, ABLE accounts can also provide financial assistance. ABLE accounts are tax-advantaged accounts specifically designed to support savings for individuals with disabilities to cover related expenses. In Massachusetts, they are administered by Fidelity Investments under the "Able Accounts" section on the Fidelity website.

These accounts and savings plans can significantly alleviate the financial burden of autism care and treatment. It's recommended that families explore these options and consult with a financial advisor or healthcare professional to understand how these can be optimally utilized to their benefit.

Making a Financial Plan for Autism

Creating a financial plan for autism is an essential step for families looking to secure a stable future for their child with autism. This involves understanding budgets for autism care and learning how to navigate autism grants and scholarships.

Creating a Budget for Autism Care

Creating a budget for autism care is a necessary step for families dealing with the financial implications of autism. This includes factoring in the costs of therapies, medical equipment, prescriptions, and other necessary expenses. Autism Speaks provides a Special Needs Financial Planning Tool Kit to aid families in developing a financial plan for their child with autism. This toolkit includes information from experts in the field and personal stories from caregivers, offering a comprehensive guide to financial planning for autism.

In some cases, savings programs designed for people with disabilities can also be utilized. For instance, the Achieving a Better Life Experience (ABLE) Act allows states to create savings programs for individuals with disabilities. Money deposited into these ABLE accounts can be used for qualified disability expenses and is not taxed when withdrawn for such expenses. In Massachusetts, for example, ABLE accounts are administered by Fidelity Investments and are specifically designed to support savings for individuals with disabilities, covering related expenses.

Navigating Autism Grants and Scholarships

In addition to creating a budget, navigating autism grants and scholarships can be an effective way to cover essential costs. There are various organizations and foundations that offer financial assistance to families of children with autism.

For example, the United Healthcare Children’s Foundation provides medical grants up to $5,000 to help pay for child health care services, like therapy, prescriptions, and medical equipment. These grants are available to children 16 years of age or younger who meet economic guidelines and are covered by a commercial health insurance plan.

The Oracle Health Foundation also offers pediatric grants with the aim to connect children to needed medical care. These grants help families overcome financial constraints and insurance limitations they may face while covering their child’s medical expenses [5].

Overall, developing a financial plan for autism involves a combination of budgeting, savings, and taking advantage of available grants and scholarships. While it can be a complex process, the right resources and information can make it considerably more manageable for families dealing with autism.

References

[1]: https://iacc.hhs.gov/resources/organizations/private/

‍[2]: https://www.incharge.org/debt-relief/financial-assistance-special-needs-children/

‍[3]: https://www.autismspeaks.org/financial-autism-support

‍[4]: https://www.aboutkidshealth.ca/financial-support-for-autism-spectrum-disorder-asd

‍[5]: https://www.autismspeaks.org/autism-grants-families

‍[6]: https://massairc.org/factsheets/getting-help-covering-co-pays-deductibles-and-other-co-insurance/