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Medicaid Waiver Guide – Massachusetts

Healthcare can be a complex maze, especially when you’re a parent of a neurodivergent child. You’re more than just a caregiver—a tireless advocate, a relentless researcher, and a steadfast champion. This guide aims to be your compass, guiding you through the twists and turns of Massachusetts Medicaid. Let’s walk this path together.

Decoding Massachusetts Medicaid

In essence, Massachusetts Medicaid is a joint state and federal program. It provides health coverage for individuals with low income. This includes some adults, children, pregnant women, elderly adults, and people with disabilities. But for families with neurodivergent kids, it’s much more than that—it’s a lifeline.

With Massachusetts Medicaid, a variety of waivers are available. Each one has its unique eligibility requirements and benefits. These waivers can cover a range of services, from home health care to specialized therapies. Getting to grips with each waiver’s intricacies can be challenging. Still, it’s crucial to ensure your child receives the best possible care.

Navigating the Application Process

Applying for Massachusetts Medicaid can feel like a daunting task. But breaking it down into manageable steps can make the process more manageable. You’ll need to gather the necessary documentation, complete the application, and participate in an eligibility determination process. Patience and persistence are essential during this process.

It’s important to note that each waiver has its own application process. For example, the Autism Spectrum Disorder (ASD) waiver may require more documentation than other waivers. Therefore, it’s crucial to understand the specific requirements of the waiver you’re applying for.

Other online resources for Massachusetts:

Telephone Resources

You can contact the Department of Developmental Services (617) 727-5608 to get more information on any of this information.

massachusetts medicaid. a parent meets with a medicaid specialist.
Read more: Special Education Schools in MA | Parent Guide

Massachusetts Medicaid Waivers for Neurodivergent Kids

Several Massachusetts Medicaid waivers specifically cater to neurodivergent kids. These waivers aim to provide services that support these kids’ unique needs and help them thrive in their communities. For example, the Autism Spectrum Disorder (ASD) waiver provides social skills training and behavioral health counseling services.

Similarly, the Intellectual Disability (ID) waiver offers support like respite care and assistive technology. These supports can be instrumental in helping your child navigate daily life. Tools like Goally, a learning tablet for kids, can be covered under these waivers, providing your child with an engaging and accessible learning platform.

Maximizing Massachusetts Medicaid Benefits

Once you’ve secured Massachusetts Medicaid for your child, the next step is to maximize these benefits. This means ensuring your child receives all the services they’re eligible for. Working closely with your child’s healthcare provider, regularly reviewing your child’s needs, and staying updated on any changes to Massachusetts Medicaid policies can help you achieve this.

Moreover, leverage technology to support your child’s development. Goally, for instance, offers a range of apps designed specifically for neurodivergent kids. These apps can complement the services provided by Massachusetts Medicaid, creating a comprehensive support system for your child.

Support Along the Way

Remember, you’re not alone in this journey. There are numerous resources available to help you navigate Massachusetts Medicaid. Advocacy groups, social workers, and online communities of parents in similar situations can provide invaluable support and guidance.

Moreover, remember to underestimate the power of shared experiences. Connecting with other parents who have navigated Massachusetts Medicaid can provide practical tips and emotional support. After all, it takes a village to raise a child—especially when raising a neurodivergent child.

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In the end, navigating Massachusetts Medicaid for your neurodivergent child may be challenging, but it’s far from impossible. With patience, persistence, and the right information, you can secure the services your child needs to thrive. You’re not just a parent—you’re a champion. And remember, every champion needs a good compass. Let this guide be yours.

Who Can Apply?

Circumstances/Diagnosis: Any child under 9 who is diagnosed with autism. The state requires that individuals need at least an intermediate care facility level of care to qualify. This has a technical definition but essentially just means that the individual is unable to get through their day without a lot of supervision.
Income: Household income cannot exceed 150% of the federal poverty line.

What do I get?

Expanded habilitation, education, in-home services and supports such as ABA therapy and floor time for 3 years. After three years families receive ongoing supplemental services like respite.

How do I apply?

Contact the Autism Division of the Department of Developmental Services (DDS) at 1-888-367-4435

What does the Goally Team Think?

Massachusetts has an unorthodox waiver program because they don’t have traditional expanded services for families with disabilities; they just have two different main programs that waive income requirements for individuals so that they can have medicaid services. Other states have programs like ASD waiver that provide specialized services for thousands of individuals for life. Massachusetts’ ASD waiver only helps out 325 children for a short, albeit critical, period of time. We think the state is on the right track they just need a few extra specialized services to make them a top notch provider.

This post was originally published 02/16/2021. It was updated on 09/17/2023.