MassHealth and autism support

Children and young adults with autism now qualify for MassHealth in Massachusetts, with no income limits.

This means your child may be able to get MassHealth, even if your family does not qualify. They can qualify because of their disability rather than the family's income.

Even if you have private insurance, you can get MassHealth as secondary insurance for your child.

This can help pay for:

  • Therapies like ABA, speech and OT

  • Diapers for kids over 3 years old

  • In-home services from Personal Care Attendants (PCAs) if your child needs help with activities of daily living like bathing, dressing and using the bathroom

  • Equipment or communication devices

Learn more about applying to MassHealth and getting the benefits your child needs! See our Health Insurance Guide. (Click on the title to open it in a new window.) 

 

MassHealth will cover ABA and other therapies for people with autism who are:

  • Under 21 and have MassHealth Standard or MassHealth CommonHealth

  • Under 19 and have MassHealth Family Assistance (Note that this is not the same as Premium Assistance)

MassHealth started to cover ABA in 2015. You can get ABA through MassHealth, but you'll need prior authorization. This is a formal approval from your insurance before they can pay for the services.

Here's how to get coverage for ABA or other therapies:

  1. Find a therapy provider. See our Resource Directory to search for providers near you.

  2. Have your provider contact MassHealth at 617-847-3786 to request prior authorization.

  3. Call the number on the back of your MassHealth card if you have questions.

If you need help, call the Autism Insurance Resource Center at 744-455-4056. Or see this Fact Sheet on their website:  Accessing ABA therapy through insurance. (Click on the title to open it in a new tab.)

Sources: Autism Insurance Resource Center, Shriver Center of UMass Medical School

 

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