09/18/2025
ASK THE INSURANCE GURU:
"Hi Guru,
Can you share information about the Autism Waiver program? When can I apply?
Jenna"
Dear Jenna,
Here are details on eligibility for the waiver and how to apply.
2025 Massachusetts autism waiver program
The Massachusetts Department of Developmental Services (DDS) will hold the 2025 application period for the Children's Autism Waiver Program from
October 17 to October 31, 2025. Applications must be submitted during this two-week window and will not be accepted outside of these dates.
Important updates and deadlines for 2025
• Open application period: October 17–31, 2025.
• Application resubmission required: If you submitted an application during the October 2024 period, you must resubmit a new one for 2025.
• No hand-delivered applications: The Autism Division will not accept hand-delivered submissions.
• Submission methods: You can submit your application online, by email, or by mail. Electronic submissions are preferred.
• Increased spending limits: Several annual spending limits under the waiver have been increased:
o Assistive technology: Up from $1,200 to $1,500.
o Individual goods and services: Up from $1,700 to $2,000.
o Emergency needs: Up from $6,000 to $6,500.
About the program
The Children's Autism Waiver Program is a Medicaid program administered by the DDS to provide in-home and community-based services for children with an autism spectrum disorder. It offers:
• Intensive services: Up to three years of one-on-one interventions, including Applied Behavioral Analysis (ABA) and other behavioral, social, and communication-based therapies.
• Supplemental services: After the intensive period, families can access supplemental supports like community integration activities and respite care until the child's 10th birthday.
Eligibility requirements
To be eligible for the waiver program, a child must:
• Have a confirmed autism spectrum disorder diagnosis, verifiable by the DDS.
• Be a resident of Massachusetts.
• Be between birth and age 9. A child can remain in the program until their 10th birthday.
• Be eligible for MassHealth Standard based on family income, not exceeding 150% of the Federal Poverty Level (FPL). Members enrolled in MassHealth CommonHealth secondary insurance are not eligible. Members enrolled in Family Assistance, CMSP or Limited plans do not qualify.
• Meet the level of care required for services in an Intermediate Care Facility for persons with an Intellectual Disability (ICF/ID).
How to apply
Applications will be available in September 2025. You can submit your application via one of the following methods during the October 17–31 window:
• Online: Use the link on the Mass.gov DDS website.
• Email: Send the form to AutismDivision@mass.gov. The email must be from a parent or guardian.
• Mail: Send the form to the Autism Division at the address provided on the application.
For assistance with the application process, you can contact a local Autism Support Center or email AutismDivision@mass.gov.
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!
