Medicaid Waiver…What Is It?

Parents of a child with autism can apply for the Family Supports Waiver (FSW) for their child. This program is funded by Medicaid and allows families to access funding for services which will help build independence, increase community supports, and lead to improvement of the individual’s quality of life.

A few of the services available to individuals in Indiana under the FSW include Behavioral Support Services, Family and Caregiver Training, Music Therapy, and Respite. The Family Supports Waiver allows an individual to access services within a total budget of $17,300.00 per year. Case management is a required part of this budget.

Individuals with autism can qualify for the waiver regardless of their parents’ income, if they meet the following requirements:

• Diagnosed with an intellectual disability, developmental disability, or related condition before age 22.
• Substantial functional limitations in at least three of six major life areas for Level of Care. These areas include self-care, learning, self-direction, capacity for independent living, understanding and use of language, and mobility.
• Assets of the individual are below a set limit.

Once on the Waiver, the individual will apply for and receive Traditional Medicaid. For those with a commercial or private insurance plan, Medicaid would then act as a secondary insurance for doctor’s visits and other health insurance needs at those providers who accept Traditional Medicaid. This can be helpful to families with high deductibles.

For a copy of the necessary forms to apply for the Family Supports Medicaid Waiver, assistance in filling out the forms, or for questions, contact your local BDDS (Bureau of Developmental Disabilities Services) office by calling the appropriate office for their county, found at this link: http://www.in.gov/fssa/ddrs/4088.htm. Once forms are submitted, it takes about one year to receive approval.

Cornerstone Autism Center has created a webinar to help parents fill out the waiver application forms, click here to watch the webinar.

Last updated by Morgan McClellan at November 23, 2021.