As a parent of a child on the autism spectrum, you’re fully aware that navigating available resources can feel overwhelming for your family, and having access to the right support makes all the difference in helping your child thrive.
At Abacus Therapies, we’ve worked with multiple North Carolina families who’ve asked us about available benefits and financial assistance. That’s why we’ve created this comprehensive guide about autism benefits in North Carolina, to help you understand what support is available for your family.
In this guide, we’ll walk through the services available across the state and highlight the benefits that can help offset (or sometimes completely cover) the costs of therapy.
North Carolina Autism Services: An Overview
According to North Carolina autism laws, there are various services designed specifically for children and adults on the autism spectrum, as well as their parents and caretakers.
Let’s look at some options that might benefit your family.
Types of Available ASD Therapies in North Carolina
ABA Therapy
Applied behavior analysis (ABA) therapy for children is widely recognized by clinicians throughout North Carolina as an evidence-based, effective approach for supporting children with autism.
ABA therapy focuses on creating personalized treatment plans that help children of all ages develop the skills they need to live more fulfilling lives and succeed in school. Each child’s program is uniquely tailored to their specific needs, interests, and learning style.
At Abacus Therapies, we’ve seen firsthand how personalized ABA therapy helps children grow and connect with their world in meaningful ways.
Our team of BCBAs (Board Certified Behavior Analysts) and RBTs (Registered Behavior Technicians) works collaboratively with families, providing ongoing support and adjusting approaches based on your child’s progress.
We’re also excited to share that our new ABA therapy center in Charlotte is now open, providing even more options for families.
TEACCH
While ABA therapy is the most popular, other effective approaches are available for children with ASD. TEACCH (Treatment and Education of Autistic and Related Communication-Handicapped Children), developed by researchers at the University of North Carolina, offers another structured approach that works well for some children.
Additional Autism Services
Other sought-after autism services your family could benefit from include:
- Family support (including ABA training for parents)
- After-school care programs
- Recreational opportunities
- Employment support for adults
- Adult day programs with vocational and social skills training
At Abacus Therapies, we recognize that parent involvement is crucial for a child’s progress. That’s why we offer specialized ABA classes for parents, giving you practical strategies to support your child’s development at home.
Residential Placement Options for an Autistic Child in NC
In some situations, children or adults with autism may require more intensive support than what parents and caretakers are able to provide. You’ll find several residential service options in North Carolina for those needing round-the-clock care.
These services most often involve group living facilities for kids and adults with ASD, but also include:
- Intermediate Care Facilities (ICF/IDD)
- Homes for Developmentally Disabled Adults (DDA)
- Alternative Family Living (AFL)
Services for Adults with Autism in North Carolina
While ABA and TEACCH typically serve children through age 20, adults on the spectrum can access vocational training, life skills programs, and the newer Research Based – Behavioral Health Treatment (RB–BHT).
To explore RB-BHT services, you should submit a request through their health insurance provider.
Benefits for an Autistic Child in North Carolina
As a parent of an autistic child in North Carolina, you have access to several benefits that could help your family cover the cost of ASD treatment. Naturally, you should first look into your health insurance provider to help with the expenses, but other financing options are also available.
Let’s explore all of them!
Medicaid Coverage for Autism in NC
Based on federal guidance issued in July 2014, all states must cover medically necessary ASD therapies for children under 21. This coverage includes:
- Insurance coverage for ABA therapy
- Certain TEACCH programs
- Other treatments for autism and related developmental disorders
What’s more, this rule applies even if the State Medicaid Plan doesn’t cover these services for adults aged 18–21.
In North Carolina, children on the spectrum may be eligible for:
- Medicaid Home and Community-Based (HCB) Waiver
- Early and Periodic Screening, Diagnostic, and Treatment (EPSDT)
- Medicaid State Plan Services
- Local Management Entity/Managed Care Organizations (LME/MCO) Non-Medicaid Services
- Medicaid “B3” Services (designed by the LME/MCO using Medicaid funds)
If you have a child under 3 years old, your clinician can submit financial assistance requests to the Division of Child and Family Wellbeing within the North Carolina Department of Health and Human Services.
For children aged 3–21, requests go to the LME/MCO under the EPSDT benefit.
Which Families Are Eligible for the Benefits?
Eligibility for autistic children benefits in North Carolina requirements vary by program. For example, HCB Waiver eligibility doesn’t consider parental income, while other state-funded programs may.
When income is considered, the state might offer co-pays or determine eligibility based on whether family income exceeds certain thresholds.
For specific eligibility information, we recommend contacting your Medicaid administrator directly.
Private and Special Insurance Coverage for Autism in North Carolina
Under North Carolina state law, major private insurers must provide autism treatment coverage for children 18 and younger, with maximum coverage set at $40,000 per year.
However, not all insurance plans fall under this regulation, so it’s best to verify coverage with your plan administrator or the North Carolina Department of Insurance.
Other insurance options that typically cover autism treatments include:
- Tricare (includes ABA therapy)
- North Carolina State Health Plan (ABA included; capped at $36,000/year)
- Federal Employee Health Benefit Plans (all plans include ABA)
It’s important to note that employer-provided self-funded health insurance plans aren’t subject to North Carolina state laws and may not cover autism treatments.
If you have a self-funded plan, contact the US Department of Labor or your plan administrator for information.
Additional Financing Options in NC
Many autism advocacy organizations offer grants and financial assistance for families. While availability varies in North Carolina, these can be valuable resources worth exploring.
We recommend contacting organizations directly to confirm eligibility and application procedures.
For teens and adults with autism, additional financial support options include:
- Health Savings Accounts (HSA)
- North Carolina Vocational Rehabilitation Services
- Achieving a Better Life Experience (ABLE) accounts (which are expanding the disability onset age expanding to age 46, starting January 1st 2026).
Private Payments
Some employers offer educational assistance programs that can help with therapy costs. These programs may provide funds through private trusts to support employees whose children need specialized services like ABA therapy.
While these typically won’t cover expenses entirely, they can significantly reduce out-of-pocket costs depending on your family’s situation.
Moving Forward Together
Finding the right support for your child takes time, but understanding your options is an important first step. Every child’s journey is unique, and at Abacus Therapies, we’re committed to helping you navigate available resources.
If you’re considering ABA therapy for your child, our team of experienced therapists offers personalized sessions at home, school, and our recently opened ABA center in Charlotte, NC.
Ready to learn more? Schedule a free consultation with our team. We’re here to support your family every step of the way.
FAQs
What benefits do autistic children get in NC?
Autistic children in NC and their parents have access to a range of benefits, including various treatment options, after-school care programs, residential placement with round-the-clock care, and recreational opportunities. Financial benefits include insurance coverage, scholarships and grants, and health savings accounts.
Can a child with autism get Medicaid in NC?
Yes, Medicaid in North Carolina covers medically necessary ASD treatments for children under 21, including ABA therapy and other interventions for autism and related developmental disorders.
Can I get paid to stay home with my autistic child in North Carolina?
Some programs, including certain Medicaid options and Supplemental Security Income (SSI), provide monthly stipends to help cover care costs. While the stipend might be enough to cover all the expenses, thus allowing you to leave work and take care of your child full-time, you must meet the eligibility requirements for your chosen financing option.
There may also be cash and counseling programs that allow you to become your child’s paid caregiver.
