Insurance Resource Center for Autism and Behavioral Health

08/01/2026

ASK THE INSURANCE GURU:

"Hi Guru,

Does someone need to have an autism diagnosis to get assistance from the Insurance Resource Center, or can they help other people who have insurance questions?

Thank you!

Provider A"

Hi Provider A,

Thank you for reaching out. The Insurance Resource Center’s (IRC) focus is to help people with insurance issues related to autism and behavioral health. That being said, they do not turn people away who don’t have a specific autism (or any other) diagnosis.

For people seeking assistance with MassHealth secondary insurance, they provide information and guidance per their attached Fact Sheet. And for people who have questions about cost/benefit of MassHealth secondary insurance they are able to help them analyze what the estimated premium might be, whether they will be eligible for Premium Assistance, etc. But as a rule, we don’t provide direct application assistance, except in rare circumstances. When families require or need direct application assistance, they usually refer them to MassHealth and/or Certified Application Counselors or other resources that can assist them in completing the application.

Please continue to refer families to the IRC, with the understanding that they are a small center and not able to provide step-by-step direct application assistance.

(Though this Fact Sheet does include them: https://massairc.org/wpcontent/uploads/2025/03/CommonHealth.pdf.)

And note that, if they are seeking in-depth application assistance they may refer them to other resources.

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.

06/01/2026

https://umassmed.zoom.us/meeting/register/6rWkkUYwS8iY1K6rIjAJKA

05/01/2026

http://meet.google.com/fwh-xwtc-swx

30/12/2025

As we come to the end of a very long year, it’s clear that the challenges we faced are only going to increase. Changes in Federal policy taking effect in 2026 will create additional barriers to healthcare access and essential services our families rely on.

As one parent recently wrote: “The landscape of resources to assist with disability benefits and related questions often feels scarce and hard to access, and I am very grateful for the attentive care you provide”

We are very proud of the incredible work we do and are committed to providing access to our resources at no charge. But it takes substantial funding to maintain the high quality of our work and support the infrastructure that allows us to be so effective. Please consider a donation to help us continue our work!

Give to UMass Medical School

23/12/2025

The Flutie Foundation proudly presents the 2nd Annual Meals for Autism Program

The Doug Flutie, Jr. Foundation for Autism is excited to announce it's 2nd Annual nationwide initiative for families in the autism community. A complimentary meal at Jersey Mike’s for individuals with autism and their immediate families.

Jersey Mike’s, a steadfast supporter of the autism community, continues to champion inclusivity across its nationwide locations while serving up their delicious subs. This partnership provides families with an opportunity to relax, share a meal, and experience the kindness behind this generous program!

How It Works
If your families are interested in participating, here are the simple steps:

Click the link here: or use the button below.

Pick a day that works for your family.
Fill out the necessary information to secure your complimentary meal.

Once submitted, our team will handle the rest! Meals will be prepared 24-48 hours in advance, and families can pick them up at their selected Jersey Mike’s location.

Program Details
Meals include: Up to 4 regular-size subs from a pre-set selection.

Eligibility: One free meal per family, per year. This program is exclusively for individuals with autism and their immediate families

Order Notes: Special orders and modifications are not possible at this time.

Availability: If the preferred date is full, families can revisit the link as more dates will become available throughout the year.
We encourage you to share this opportunity with the families you support, so they can enjoy a meal on us while celebrating the incredible inclusivity promoted by Jersey Mike’s.

Thank you for helping us spread the word about this exciting program!

Get Your FREE Jersey Mike's Meal: Fill Out This Form!

https://form.jotform.

Please click the link to complete this form.

23/12/2025

From all of us at the Insurance Resource Center for Autism and Behavioral Health, we wish you the happiest holidays!

Our office will be closed 12/24 and 12/25. We will reopen 12/26.

18/12/2025

ASK THE INSURANCE GURU:

"Options for MassHealth Application Assistance

Hi Guru,

I need some help updating my MassHealth application what are my options?

Simple Sue"

Hi Simple Sue,
When it comes to reporting updates, such as a change in income, birth of a child or address change, there are several ways you can make these changes.
• You can always call MassHealth and make updates over the phone.
(800) 841-2900
• If you have an account set up, you can login at www.mahealthconnector.org and report a change.
o If you need support with your online account, you’ll want to call the Health Connector - 1-877-623-6765
• You can also seek out in-person assistance from a Certified Application Counselor or a Navigator in your area. Certified Application Counselors are typically located in hospitals and health centers. Some may be able to provide support virtually via Zoom or the phone. Updated list: https://my.mahealthconnector.org/enrollment-assisters

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.

17/12/2025

11/12/2025

ASK THE INSURANCE GURU:

"Dear Guru,

My family has been relying on MassHealth premium assistance for a few years now. My husband’s health premium is going way up in 2026. He will be paying $1400/month for the family plan! Did the 2026 deductible rates or reimbursement change for 2026?

Fingers crossed!"

Dear Fingers crossed,

Yes, you are in luck and can uncross your fingers!! Premium assistance deductibles and reimbursement rates have increased for 2026. The maximum in-network deductible has increased to $3,200 for an individual and $6,400 for the family.

The individual maximum out-of-pocket has increased to $10,150. The family coverage maximum out-of-pocket has increased to $20,300. As long as your employer health plan is at or under these maximums, it should meet eligibility guidelines.

The Premium Assistance monthly reimbursement rates are as follows:

MassHealth: up to $1,835 per month
Standard disabled: up to $1,835 per month
Standard, not disabled: up to $457 per month
Family Assistance: up to $457 per month

Please remember to renew your premium assistance annually as soon as you complete your employer health plan open enrollment!
If you have questions about premium assistance, the number to call is 1.800.862.4840.

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.

08/12/2025

Click here to register: https://mdsc.zoom.us/webinar/register/WN_24xQ477eTpmLJ6iGcqC0oA?fbclid=IwY2xjawOj73BleHRuA2FlbQIxMABicmlkETFzczhjcDJYTjdVVlM2RE9nc3J0YwZhcHBfaWQQMjIyMDM5MTc4ODIwMDg5MgABHvaYueewo8VlnaOZBNyGFtipnH_oZ81fc5irV67f71JtMkIWuIOQl66PAD3W_aem_Gkb5Ds5z8r7ntENd2zJrBg #/registration

04/12/2025

ASK THE INSURANCE GURU:

"Hi Guru,

We have MassHealth, which has allowed my 15-year-old son to get out-patient therapy. My son’s therapist asked me what I thought about trying “TM” services. Once I figured out that TM is an acronym for Therapeutic Mentoring and learned a bit about it, I think it sounds like something that could be helpful. Can you tell me a little more about Therapeutic Mentoring services.

Thanks,

-Looking to learn about TM"

Dear Looking to Learn About TM,

Yes, Therapeutic Mentoring (“TM”) services can be very helpful for youths who are struggling. I tend to think of it as a skill building service. TM pairs a youth under age 21 with a mentor to help improve their social, communication and life skills in accordance with their Behavioral Health Treatment Plan.

- The TM will provide one-on-one support or coaching to help the youth with problem-solving, social skills, communication, or conflict resolution.

- The TM will practice and reinforce these new skills in a safe and appropriate setting so the youth will be able to learn how to use them.

- This skill building aims to address the goals included in the youth’s Behavioral Health treatment plan.

- Therapeutic Mentoring is a “hub-dependent” service. This means that in order to use TM services, the youth must already receive out-patient therapy, in-home therapy, Intensive Care Coordination or another MassHealth “hub” service. A referral will need to be provided from a MassHealth “hub” service, as these hubs are tasked with collaborating with state agencies and other providers to help youth and families get the right services and well-coordinated care.

- TM services need to be Medically Necessary.

So, if your child’s “hub” is suggesting TM, you may want to consider taking advantage of the benefit. You should, of course, discuss how TM services fit with your child’s Behavioral Health Treatment Plan. In many cases, it is a great fit and helps achieve established goals.

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".

04/12/2025

https://umassmed.zoom.us/meeting/register/cVCgtjFYSg-t_ouuqZWfJw