When you have a child with autism and ADHD, the costs for their treatments, medication, care and services can really add up over time. Even if you have stellar health care benefits, you still have to pay the deductible and then the coinsurance or co-pays. Many services and some treatments are not covered by health insurance, but you know your child needs them. So how can you find ways to pay for all the care and services your child with autism and ADHD needs?
Maximize your health insurance coverage
The first place to start is with your health care benefits. I found it helpful to call and talk to a member services representative to ask questions about which treatments, medications and services are covered. I have checked my health plan’s website but found it difficult to locate specific information about our benefits on there. Even though it takes more time, I think making the call was much more productive and informative for me. If your health plan has a comprehensive website, then you may be able to get all the information you need from there.
Also, be sure you understand your deductible and any coinsurance/copays. Because we had higher usage of care and services, we ditched the health savings account (HSA) that we had through my employer and instead chose the health reimbursement account (HRA)/preferred provider organization (PPO) plan. Although the premiums were a bit higher monthly, our services were covered at 90 percent for in-network providers once we met the deductible (so our share was 10 percent). With the HSA, we had to pay 20 percent in coinsurance for in-network providers and much more for any out-of-network providers. We ended up paying much more with the HSA instead of the HRA.
In other words, take a close look at the health insurance options you are offered and choose the best one for your family based on the overall benefits and costs and not just the monthly premium amounts.
Consider applying for your state’s Medicaid autism waiver
If you haven’t already applied for your state’s Medicaid waiver for autism services, you should consider applying as soon as possible. Some states have long wait lists, so it could take a year or more to start receiving services for your autistic child.
The waiver can cover services and treatments not included in your health insurance benefits, like respite care, patient and assistance care (PAC), music therapy, additional behavioral therapy, recreational therapy and so much more.
For more information about Medicaid waiver for autism services, check out the 7 reasons to apply for your state’s Medicaid Waiver for your child with autism blog post.
If you already have the Medicaid waiver for your child, you might want to read this blog post: Best ways to partner with your child’s Medicaid Waiver case manager. This explains how you can work with your child’s case manager to ensure you are making the most of these benefits.
Leverage services available through your autistic child’s school
You should ensure that you make the most of any services available through your child’s school system. For instance, can they obtain speech therapy there instead of through your health insurance? Does your child’s school offer social skills groups that they could participate in instead of going through a behavior specialist using your insurance? Do they offer any tutoring services during study hall if your child is in junior high or high school?
Using these services through your child’s school will save you out-of-pocket costs in the long run – and you are already paying for them through your taxes!
Include a medical sinking fund in your budget
One way to continually put money aside to pay for the care and services your child with autism and ADHD needs is by having a medical sinking fund in your budget.
What is a sinking fund? These are categories in your budget that account for regular expenses that don’t necessarily come monthly but still need to be accounted for on a monthly basis to build up the money to pay for them. Those can include car repairs, quarterly insurance payments, annual subscriptions, medical expenses, vacation and more. (For more information, see my article about sinking funds on Medium, where I write about personal finance topics.)
I put money from each paycheck into our medical sinking fund in our You Need a Budget (YNAB) budget and also add money from my annual bonus check to that category. It really helps to pay for the medical invoices and prescriptions as they come in throughout the year.
Apply for autism grants and scholarships
Did you know there are autism grants and scholarships to help you pay for a variety of care and services for your child with autism?
You can find out more details – including the sites and links to apply – in this blog post.
Check to see if your child qualifies for Social Security Income
If your child is more profound on the autism spectrum, they may meet the disability requirements for Social Security Income (SSI). SSI requirements also have strict income limitations for your family as well. However, if your child does meet the requirement and you as parents meet the income level criteria, it would be good to go through the process to apply for SSI. You could use that income to help pay for the care and services your child needs.
To find out more, check out this blog post about SSI.
Use crowdfunding for really big expenses
I have seen parents of autistic children successfully use crowdfunding for really big expenses like raising money to obtain an assistance dog for their child.
Here is an article on the GoFundMe website that talks specifically about setting up a campaign for autism and some examples for how parents or loved ones have done this successfully. I also note a resource below that gives more information about the various crowdsourcing sites and how to set up a campaign.
One word of caution – be sure to understand the tax implications for the money you raise. You will have to pay taxes on it, so you can discuss with an accountant if you anticipate raising a lot of money (for example $20,000 or more for an assistance dog).
Do you have any other ideas about how to pay for care and services your child with autism and ADHD needs? Leave a comment below so that we can share and encourage each other on this journey!
Additional resources
Want to dive deeper into this topic? Check out these additional resources for more information.
Autism and Your Family Finances (affiliate link)
Funding Autism Treatment (affiliate link)
Making Them Pay: How to Get the Most from Health Insurance and Managed Care (affiliate link)
When the School Says No . . . How to Get the Yes!: Securing Special Education Services for Your Child (affiliate link)
Crowdfunding Basics In 30 Minutes (In 30 Minutes Series): How to use Kickstarter, Indiegogo, and other crowdfunding platforms (affiliate link)
