Insurance Resource Center for Autism and Behavioral Health

29/01/2026

ASK THE INSURANCE GURU:

"Dear Guru,

I have a 4-year-old child who has been attending a center-based ABA program for the past year. We have been happy with our provider, but something happened last week that I am still concerned with. When I picked up my son, he had a raised welt on his cheek. The provider said they had no idea where the bruise came from. I asked the BCBA, and they said they would look into it, but they haven’t been able to tell me what actually happened.

I am still concerned about bringing my son back to the center. What should I do?"

I am very sorry that this happened, and you have every right to be concerned. I hope your son is okay.

First of all, you have every right to have the provider explain what happened. The reality is that while a child is in an ABA program, they should be with a technician or BCBA for the entirety of the time they are receiving treatment. So, I do think you have cause for concern if they don’t know what happened. I would suggest that you ask for a meeting with the provider and ensure they have an answer as to what happened, and what they will do to prevent anything like this happening again.

Secondly, you should know that you can contact the Department of Children and Families (DCF). The number for the Child-at-Risk-Hotline is 800-792-5200. You can call to report your concerns. For additional resources, you can find information for your local DCF office here.

Finally, you have the option of reporting this to your health insurance company to let them know you have a complaint against one of the providers in their network. The Health plan can document your account of the situation and this may result in further investigation.

Reminder:

I am the Autism Insurance Guru and every week (or as often as I can) I answer your autism insurance related questions here on the AIRC’s page. My advice and wisdom come from years of experience dealing with autism insurance in Massachusetts, but please note anything I share is NOT intended to be legal or medical advice. I will post answers to questions that are submitted.

If you would like your autism insurance related questions answered by the Guru, please send them via email to AIRC@umassmed.edu with the subject line "Insurance Guru".

22/01/2026

ASK THE INSURANCE GURU:

"Dear Guru:

My patient’s insurance recently changed, and the new insurance requires that I provide a copy of the child’s Individual Education Plan (IEP). I am not sure I should be sharing this. Can you advise?

ABA provider"

Dear ABA Provider – This is a very concerning requirement.

The IEP is subject to a Federal Law, The Family Educational Rights and Privacy Act (FERPA). Submitting the IEP to insurance would be a violation of FERPA.
In many cases, it’s helpful for families to share a copy of the IEP with their ABA provider to help develop and coordinate a treatment plan. But sharing the IEP does not give you, as the provider, permission to submit it to insurance.

As part of the authorization review, an insurer can request information about school services, but they should not be requiring a copy of the IEP. I would explain to them that you are not able to share the IEP, and if this prevents you from getting an authorization, please reach out to my colleagues at the Insurance Resource Center for advice.

Reminder:

I am the Autism Insurance Guru and every week (or as often as I can) I answer your autism insurance related questions here on the AIRC’s page. My advice and wisdom come from years of experience dealing with autism insurance in Massachusetts, but please note anything I share is NOT intended to be legal or medical advice. I will post answers to questions that are submitted.

20/01/2026

https://umassmed.zoom.us/meeting/register/-rv_MEf-QReeVIv10fVfSA

15/01/2026

ASK THE INSURANCE GURU:

"Dear Guru,

I am a provider working with a family who could really benefit from your services, but the family does not speak English. Are you able to help families who speak other languages?"

Dear Provider,

Yes, absolutely! We are happy to support families whose first language is not English, and we can assist families of all language backgrounds. We have a Spanish speaking staff member who can work directly with Spanish speaking families. For families who speak other languages, we use a professional language line that gives us access to interpreters in over 240 spoken languages, including video conferencing to accommodate American Sign Language.

We also translate many of our written materials. Our fact sheets on varying insurance topics are available in multiple languages, including Spanish, Vietnamese, Portuguese, Simplified Chinese, and Haitian Creole. These can be a great resource for families and providers. You can find all of our translated fact sheets on our website at https://massairc.org/fact-sheets/ -content.

Language should never be a barrier to getting help. We are committed to meeting families where they are and ensuring they can access the support they need.

Reminder:

I am the Autism Insurance Guru and every week (or as often as I can) I answer your autism insurance related questions here on the AIRC’s page. My advice and wisdom come from years of experience dealing with autism insurance in Massachusetts, but please note anything I share is NOT intended to be legal or medical advice. I will post answers to questions that are submitted.

If you would like your autism insurance related questions answered by the Guru, please send them via email to AIRC@umassmed.edu with the subject line "Insurance Guru".

The Guru is happy to hear from you!

08/01/2026

ASK THE INSURANCE GURU:

"Hi Guru,

Does someone need to have an autism diagnosis to get assistance from the Insurance Resource Center, or can they help other people who have insurance questions?

Thank you!

Provider A"

Hi Provider A,

Thank you for reaching out. The Insurance Resource Center’s (IRC) focus is to help people with insurance issues related to autism and behavioral health. That being said, they do not turn people away who don’t have a specific autism (or any other) diagnosis.

For people seeking assistance with MassHealth secondary insurance, they provide information and guidance per their attached Fact Sheet. And for people who have questions about cost/benefit of MassHealth secondary insurance they are able to help them analyze what the estimated premium might be, whether they will be eligible for Premium Assistance, etc. But as a rule, we don’t provide direct application assistance, except in rare circumstances. When families require or need direct application assistance, they usually refer them to MassHealth and/or Certified Application Counselors or other resources that can assist them in completing the application.

Please continue to refer families to the IRC, with the understanding that they are a small center and not able to provide step-by-step direct application assistance.

(Though this Fact Sheet does include them: https://massairc.org/wpcontent/uploads/2025/03/CommonHealth.pdf.)

And note that, if they are seeking in-depth application assistance they may refer them to other resources.

Reminder:

I am the Autism Insurance Guru and every week (or as often as I can) I answer your autism insurance related questions here on the AIRC’s page. My advice and wisdom come from years of experience dealing with autism insurance in Massachusetts, but please note anything I share is NOT intended to be legal or medical advice. I will post answers to questions that are submitted.

06/01/2026

https://umassmed.zoom.us/meeting/register/6rWkkUYwS8iY1K6rIjAJKA

05/01/2026

http://meet.google.com/fwh-xwtc-swx

30/12/2025

As we come to the end of a very long year, it’s clear that the challenges we faced are only going to increase. Changes in Federal policy taking effect in 2026 will create additional barriers to healthcare access and essential services our families rely on.

As one parent recently wrote: “The landscape of resources to assist with disability benefits and related questions often feels scarce and hard to access, and I am very grateful for the attentive care you provide”

We are very proud of the incredible work we do and are committed to providing access to our resources at no charge. But it takes substantial funding to maintain the high quality of our work and support the infrastructure that allows us to be so effective. Please consider a donation to help us continue our work!

Give to UMass Medical School

23/12/2025

The Flutie Foundation proudly presents the 2nd Annual Meals for Autism Program

The Doug Flutie, Jr. Foundation for Autism is excited to announce it's 2nd Annual nationwide initiative for families in the autism community. A complimentary meal at Jersey Mike’s for individuals with autism and their immediate families.

Jersey Mike’s, a steadfast supporter of the autism community, continues to champion inclusivity across its nationwide locations while serving up their delicious subs. This partnership provides families with an opportunity to relax, share a meal, and experience the kindness behind this generous program!

How It Works
If your families are interested in participating, here are the simple steps:

Click the link here: or use the button below.

Pick a day that works for your family.
Fill out the necessary information to secure your complimentary meal.

Once submitted, our team will handle the rest! Meals will be prepared 24-48 hours in advance, and families can pick them up at their selected Jersey Mike’s location.

Program Details
Meals include: Up to 4 regular-size subs from a pre-set selection.

Eligibility: One free meal per family, per year. This program is exclusively for individuals with autism and their immediate families

Order Notes: Special orders and modifications are not possible at this time.

Availability: If the preferred date is full, families can revisit the link as more dates will become available throughout the year.
We encourage you to share this opportunity with the families you support, so they can enjoy a meal on us while celebrating the incredible inclusivity promoted by Jersey Mike’s.

Thank you for helping us spread the word about this exciting program!

Get Your FREE Jersey Mike's Meal: Fill Out This Form!

https://form.jotform.

Please click the link to complete this form.

23/12/2025

From all of us at the Insurance Resource Center for Autism and Behavioral Health, we wish you the happiest holidays!

Our office will be closed 12/24 and 12/25. We will reopen 12/26.

18/12/2025

ASK THE INSURANCE GURU:

"Options for MassHealth Application Assistance

Hi Guru,

I need some help updating my MassHealth application what are my options?

Simple Sue"

Hi Simple Sue,
When it comes to reporting updates, such as a change in income, birth of a child or address change, there are several ways you can make these changes.
• You can always call MassHealth and make updates over the phone.
(800) 841-2900
• If you have an account set up, you can login at www.mahealthconnector.org and report a change.
o If you need support with your online account, you’ll want to call the Health Connector - 1-877-623-6765
• You can also seek out in-person assistance from a Certified Application Counselor or a Navigator in your area. Certified Application Counselors are typically located in hospitals and health centers. Some may be able to provide support virtually via Zoom or the phone. Updated list: https://my.mahealthconnector.org/enrollment-assisters

Reminder:

I am the Autism Insurance Guru and every week (or as often as I can) I answer your autism insurance related questions here on the AIRC’s page. My advice and wisdom come from years of experience dealing with autism insurance in Massachusetts, but please note anything I share is NOT intended to be legal or medical advice. I will post answers to questions that are submitted.

17/12/2025