Financial Planning: Understanding Financial Considerations Related to Raising a Child with Autism

Raising a child with autism speectrum disorder (ASD) presents not only emotional and developmental challenges, but also significant financial ones. From medical and therapeutic expenses to educational and long-term care costs, the economic burden can be high. Families need to understand what to expect, how to plan, and what financial assistance and insurance options are available.

This post aims to guide parents, caregivers, and professionals through financial planning strategies, insurance coverage, and assistance programs available in Florida and Georgia, drawing on current studies and expert sources.

The True Costs of Raising a Child with Autism

It costs an estimated $233,610 to raise a child to age 17, according to the U.S. Department of Agriculture. A study conducted in 2020 found out that “the average per capita cost of ASD is $3,566,881

Variation due to comorbidities: Children with ASD and associated conditions (e.g. intellectual disability, ADHD, seizure disorder, anxiety, pica, depression and more) incur far greater average annual healthcare expenditures compared to ASD alone. One study found ~$7,200/year for ASD without comorbidities vs ~$19,190 for ASD plus intellectual disability.

Non-medical and indirect costs: Travel, lost parent wages, educational supports, specialized therapies outside insurance, adaptive equipment, etc. These can be substantial. Studies show many families spend more than 3% of their household income on out-of-pocket health related care for their child with ASD.

Key Insurance Considerations

Families’ Financial Burden of Raising Children with Autism (Brandeis University, etc.) shows more than one-third of families with any out-of-pocket expenses spend more than 3% of their household income on ASD-related health care costs. More generous Medicaid programs at the state level are associated with lower burdens.

Private Health Insurance

• Verify whether behavioral therapy (ABA or similar) is covered. Many state mandates require private insurers to cover autism-related services. Check Autism and Insurance Coverage State Laws Here
• Understand deductibles, co-pays, co-insurance, out-of-pocket maximums. Some plans limit therapy hours or impose caps.

Medicaid

For many families with limited income, Medicaid can cover diagnostic and treatment services, often including behavioral health interventions. Especially important for children below certain income thresholds.

For families whose incomes are too high for Medicaid but cannot afford private insurance. Coverage varies by state. Often provides vaccines, dental, well-child care, behavioral health.

Other Supports

• Children’s Health Insurance Program (CHIP): For families whose incomes are too high for Medicaid but cannot afford private insurance. Coverage varies by state. Often provides vaccines, dental, well-child care, and behavioral health.
• Autism Care Today SOS Program provides financial assistance for immediate and emergency care needs for a child with autism.
• Supplemental Security Income (SSI) / SSDI: For children with significant disability, SSI provides monthly income to support care. Adult benefits can continue under certain conditions.

Government & State Assistance Programs in Florida

• Florida Medicaid: Provides coverage for children with disabilities including ASD for certain therapies, diagnosis, medical services under “ Families & Children” programs. (Check local eligibility)
• Autism Hero Project offers financial assistance for prescription copays, insurance premiums, deductibles, coinsurance, behavioral health services and travel for families.
• HealthWell Foundation and ACT-Today Grants help with coverage gaps including premiums and out-of-pocket expenses.
• State Education Programs & Early Intervention: Florida’s early intervention services for children under age 3 with developmental delays, which can include autism, are federally funded via IDEA (Individuals with Disabilities Education Act). These can reduce therapy costs in early years.

Government, State Assistance  and Non-profit Programs in Georgia

• Georgia Medicaid: Provides Autism Spectrum Disorders (ASD) services for individuals under age 21, for assessment and treatment based on medical necessity.
• PeachCare for Kids: Georgia’s CHIP program provides health coverage for children whose families don’t qualify for Medicaid due to a higher income, but still need assistance. It includes behavioral health services.
• The Georgia Autism Scholarship Program (if available), and Katie Beckett Waiver in some cases, which may allow children with significant needs to receive Medicaid even if parental income is higher, provided the child meets care criteria.
• State Laws / Mandates: Georgia has various legislative efforts related to autism insurance coverage. However, the extent, caps, limits and enforcement vary, so checking current statute is important.
• The Georgia Department of Behavioral Health and Developmental Disabilities offers Family Support Services aimed at individuals aged four and up diagnosed with developmental disabilities. These services are available to those living at home with their families who are not receiving a NOW/COMP Waiver.
• Parent 2 Parent Georgia

Best Practices for Financial Planning

• Early assessment and diagnosis: Earlier diagnosis allows earlier intervention, which often reduces long-term costs and improves outcomes.
• Budgeting: Include anticipated medical, therapy, transportation, equipment, and indirect costs like lost income. Create a realistic budget with possible worst-case scenarios.
• Insurance audit: Review existing insurance policies carefully. Identify what is covered, caps, limitations. If insurance doesn’t cover enough, consider supplemental coverage or alternative funding sources.
• Use state and federal programs: Apply for Medicaid/CHIP, SSI, state and local assistance early. Ensure proper documentation (diagnosis, therapy plans, letters of medical necessity).
• Planning for long term: Consider trusts (special-needs trust), savings accounts, guardianship, transition planning for adulthood.
• Tax planning: Medical expense deductions, dependent care credits, etc. Use an accountant knowledgeable in special needs.
• Explore nonprofit support & grants: Local charities, foundations often provide financial aid, equipment, therapy grants.
• Keep records: For insurance appeals, tax deductions, government assistance. Good record keeping of expenses, diagnosis, therapy progress.

Raising a child with autism has unique financial challenges but being informed can make a significant difference. Through careful insurance review, leveraging state and federal aid, early intervention, thoughtful budgeting, and tapping into grants and nonprofit support, families in Florida and Georgia can better manage costs and reduce financial strain.

If you are a parent or caregiver, start by gathering your child’s diagnosis documentation, list of needed therapies, your insurance policy, and then map out what you expect to spend annually. Then, explore what programs in your state you qualify for. Every small resource helps—not just financially, but for peace of mind.