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Our Medical Insurance Grants cover medical insurance premiums ONLY. Our grants do NOT cover deductibles, co-payments, co-insurance or any other out-of-pocket expenses. If the applicant is currently receiving Health Insurance Premium Payment (HIPP) reimbursements, please do not apply for this grant. For resources and grants to cover all other medical expenses outside of monthly medical insurance premiums, please visit our resource tab at www.autismheroproject.org/resources

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Important Information for Applicants

• Applicants MUST have a current autism diagnosis.

• Applicants MUST be a resident of Illinois or Florida.

• Applicants can be on MEDICAID, uninsured or have existing medical insurance.

• Applicant's Household income and size will be taken into consideration (Priority will go to low-income and/or families with multiple dependents on the autism spectrum.)

• Applicants MUST complete a Personal Statement explaining their need for assistance within the application.

• If awarded, applicants can use their medical insurance for any and all therapies and medical needs but we ONLY audit for ABA Therapy. 

• One application per applicant. (All family members and siblings MUST have their own application).

• Applicants MUST be seeking Applied Behavior Analysis (ABA) Therapy with a MINIMUM of 12 HOURS Weekly. (We require that all grantees maintain twelve (12) hours at a minimum of ABA per calendar week).

• Applicants should please note that new health insurance plans typically require that your dependent’s autism diagnosis be within the last three (3) years or may require that you get an updated evaluation in order to be applicable for ABA services.  

• Applicants may be contacted for a phone interview or emailed for more information.

• Applications MUST be received no later than MIDNIGHT (No Exceptions)  along with the current year's TAX RETURN AND THE TWO MOST RECENT PAY STUBS OR UNEMPLOYMENT PAY STUBS FROM YOUR APPLICATION DATE. ​

• Email your application questions and/or additional documents to applications@autismheroproject.org

 

**FAILURE TO INCLUDE ALL SOURCES OF INCOME ON THE APPLICATION INCLUDING SELF-EMPLOYMENT CAN DISQUALIFY YOUR APPLICATION.

 

If the applicant does NOT have medical insurance or has medical insurance through an employer, the state, or Medicaid that DOES NOT cover Applied Behavior Analysis (ABA) Therapy, an applicant may apply with the understanding that:

• Applicants with MEDICAID MUST apply for health insurance through a PRIVATE INSURANCE BROKER and NOT from The Marketplace otherwise known as the Affordable Health Care Act. (*This is necessary to note because The Marketplace is a government-subsidized health insurance plan and insureds are NOT allowed to have more than one type of government-subsidized insurance plan. If you make the mistake of purchasing a plan through The Marketplace, you are at risk that the applicant's MEDICAID will automatically cancel. Additionally, it is important to note that private insurance will become the applicant's primary insurance and MEDICAID will be a secondary insurance.) 

•  All other applicants without medical insurance or medical insurance that does not specifically cover ABA Therapy can apply for health insurance that will cover ABA Therapy from a private insurance broker or The Marketplace at https://www.healthcare.gov (**The Marketplace allows for premium tax credits based on income where attaining insurance from a private insurance broker may not.)

• Open enrollment period for 2023 coverage is November 1-December 15, 2022 for a January 1st, 2023 start date, otherwise open enrollment will remain open through January 15th, 2023 but will have a Feb.1st start date. 

• Marketplace recommended plans are Silver or Gold due to deductible and out-of-pocket maximum. **It may seem like BRONZE IS THE MOST AFFORDABLE MONTHLY PLAN BUT IN THE LONG-TERM CAN BE THE MOST  COSTLY BECAUSE OF DEDUCTIBLE, COPAYMENTS, COINSURANCE AND OUT OF POCKET MAXIMUMS.

• Our Medical Insurance Grant ONLY covers medical insurance premiums for an individual plan with evidence that ABA Therapy is ongoing and occurring in the month with an average minimum of twelve (12) hours weekly. Our grants do NOT cover copayments. coinsurance or other out-of-pocket costs.

• ABA Audits will occur a minimum of four (4) times throughout the year to verify therapy is taking place.

• Applicants will send AHP their monthly insurance premium invoice for reimbursement within 30 days of invoice date along with evidence that the monthly premium payments are being paid on time. AHP will not pay any late fees or other fees of any kind. Both are required in ONE email to be sent to applications@autismheroproject.org 

 

Applicants who DO have medical insurance through their employer that DOES cover ABA Therapy.

• AHP will pay the difference in coverage that covers the applicant’s portion of premium ONLY. (For Example:  If the Employee premium is $75 per pay period for medical insurance and Employee plus a dependent premium is $125.  AHP will pay the difference of coverage for the applicant in the amount of $50 ($125 - $75 = $50). Another example for an Employee who carries a family plan. Employee premium is $75 per pay period for medical insurance and the family plan premium is $125.  AHP will pay the difference of coverage for the applicant in the amount of $50 ($125 - $75 = $50).

• When completing an application if you have your Employee 2022 “Open Enrollment Plan Guide”, please use the most current employee portion payroll deductions for insurance. (*We have provided a sample of a 2021 Open enrollment guide to help you understand where your grant application amounts should be pulled from.) 

• ABA Audits will occur a minimum of four (4) times throughout the year to verify therapy is taking place.

• Applicants will send AHP evidence that monthly premium payments are being paid through employer deductions on the current pay stubs.