Columbia parents often hear about “the waiver” in the same conversation as applied behavior analysis (ABA therapy). It’s easy to assume the two are linked, or that one is needed to get the other.

Yet, they are separate programs. Maryland’s Autism Waiver and the Medicaid ABA benefit serve children with autism spectrum disorder (ASD) in different ways, with different rules and very different wait times.¹⁸

Knowing how each one works can save your family months of uncertainty.

In this article, we’ll discuss how Maryland’s Autism Waiver compares with Medicaid ABA coverage and what Columbia families should do about each.

What is the Maryland Autism Waiver?

The Autism Waiver is a Medicaid program run by the Maryland State Department of Education. It pays for home and community supports that help children with autism live safely at home.¹²

To qualify, a child must:

• Be at least 1 year old, with services available through the end of the school year in which they turn 21
• Have an autism diagnosis
• Need the level of care usually provided in an institutional setting
• Have an IEP or IFSP that includes at least 15 hours a week of special education and related services

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The financial test looks at the applicant’s own income and assets. Monthly income can’t be more than 300% of the federal SSI benefit, and countable assets are limited to $2,000 or $2,500 depending on the category.⁵

Waiver services include intensive individual support, therapeutic integration, respite care, family consultation, residential habilitation, environmental accessibility adaptations and adult life planning. Participants also receive all regular Medicaid benefits.¹⁵

The waiver’s biggest drawback is its wait time. Maryland’s most recent report on the program put the wait at six years and 10 months, and invitations to apply were paused in fiscal year 2025 because of budget limits.¹¹¹²

How is Medicaid ABA Coverage Different?

Maryland Medicaid has covered ABA therapy as a regular benefit since 2017. A child under 21 who is enrolled in Medicaid, has an autism diagnosis from a comprehensive diagnostic evaluation and has a referral can begin therapy once it’s approved.⁶⁷⁹

The biggest difference for families is timing. The ABA benefit is available as soon as a child qualifies, while the waiver depends on an open slot.⁸¹⁰

Can Your Child Use Both?

A child in the Autism Waiver keeps all regular Medicaid benefits, including ABA therapy, so many children use both programs. The waiver adds supports on top of therapy instead of replacing it.¹⁸

For Howard County families, the waiver can matter in another way. Because the financial test is based on the applicant’s own income, a child may qualify for Medicaid through the waiver even when the household earns too much for regular Medicaid. That opens the door to Medicaid-covered ABA for families who would otherwise rely on private insurance alone.³⁵

The practical advice is the same either way. Start ABA therapy through the coverage you have now, and put your child’s name on the waiver registry at the same time. There’s no reason to delay one while waiting on the other.

How Do Columbia Families Get on the Registry?

Joining the registry is a single phone call, and the earlier you call, the sooner your child’s wait begins.¹³

1. Call the Autism Waiver registry at 866-417-3480 and ask to add your child’s name.
2. Keep your address, phone number and email current, since invitations can come years later.
3. Make sure your child’s IEP or IFSP reflects the services they receive. The 15-hour requirement is part of eligibility.
4. When an invitation arrives, respond quickly and gather the medical and school records the application asks for.

Once a child enters the waiver, the local school system arranges case management. For Columbia families, that means working with the Howard County Public School System to set up waiver services.²¹⁴

Blue Gems ABA Helps Columbia Families Make Sense of Their Options

The Autism Waiver and Medicaid ABA coverage each have a role. Using both, and starting therapy without waiting for a waiver slot, gives your child the best chance to keep making progress.

At Blue Gems ABA, our team works with children on the autism spectrum at our Columbia center at 10015 Old Columbia Road and in homes across Howard County. We work with Maryland Medicaid plans, and our insurance specialists can review your coverage options with you.

Give our Columbia team a call at (443) 656-9050 or contact us to talk through your child’s next steps.

Frequently Asked Questions

Is Maryland’s Autism Waiver the same as Medicaid ABA coverage?

No. The Autism Waiver provides additional home and community supports, while Medicaid ABA coverage pays for medically necessary ABA therapy for eligible children.

Does my child need the Autism Waiver to receive ABA therapy in Maryland?

No. Children who meet Maryland Medicaid’s ABA coverage requirements can receive approved ABA therapy without enrolling in the Autism Waiver.

Can my child receive ABA therapy while waiting for the Autism Waiver?

Yes. Families can pursue ABA therapy through Medicaid or other available insurance while their child remains on the Autism Waiver registry.

Does Maryland’s Autism Waiver consider parents’ income?

The waiver’s financial eligibility rules generally evaluate the applicant’s own income and assets rather than the household’s combined income. Medical and technical eligibility requirements must also be satisfied.

Who should Columbia families call about the Autism Waiver?

Families can call the Maryland Autism Waiver registry at 866-417-3480. They can also contact their child’s school or the Maryland State Department of Education for program information.

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