Who is Eligible for Family Health Plus in NY

11 Jan 2022
Discover if you're eligible for Family Health Plus in NY! Get the support your autistic child needs with our comprehensive guide.

Understanding Autism

Autism is a complex neurodevelopmental disorder that affects individuals in various ways. It is characterized by difficulties in social interaction, communication, and repetitive behaviors. To gain a better understanding of autism, let's explore what it is and the different types of autism.

What is Autism?

Autism, or Autism Spectrum Disorder (ASD), is a lifelong condition that typically manifests in early childhood. It is a spectrum disorder, meaning that individuals with autism can experience a wide range of symptoms and levels of impairment.

Common characteristics of autism include challenges in social interaction, such as difficulty understanding social cues and maintaining eye contact. Communication difficulties may involve delayed language development or a preference for repetitive and specific language patterns. Restricted and repetitive behaviors, such as repetitive movements or fixations on certain objects or topics, are also common features of autism.

It's important to note that every individual with autism is unique, and the severity of symptoms can vary greatly. Some individuals with autism may have exceptional skills in specific areas, such as music, art, or mathematics. Early intervention, therapy, and support services play a crucial role in helping individuals with autism thrive and reach their full potential.

Types of Autism

Within the autism spectrum, there are different types of autism that are classified based on the severity of symptoms and level of support needed. These include:

  1. Autistic Disorder (Classic Autism): This is the most severe form of autism. Individuals with autistic disorder exhibit significant impairments in social interactions, communication, and have restricted and repetitive behaviors. They may have delayed language development and struggle with adapting to changes in routine.
  2. Asperger's Syndrome: Asperger's syndrome refers to individuals with higher functioning autism. They usually have average to above-average intelligence and exhibit milder symptoms. People with Asperger's syndrome often have difficulties with social interactions, communication, and may show intense interests in specific subjects or topics.
  3. Pervasive Developmental Disorder - Not Otherwise Specified (PDD-NOS): This term is used for individuals who have some symptoms of autism but do not meet the specific criteria for other types of autism. People with PDD-NOS may have milder symptoms or exhibit symptoms that do not fit into a specific category.

It's important to keep in mind that the diagnostic criteria for autism have evolved over time, and with the release of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), these specific subcategories are no longer used. Instead, autism is classified on a spectrum based on the severity of symptoms and level of support needed.

By understanding what autism is and the different types of autism, we can better support individuals with autism and promote inclusivity within our communities.

Support Services in New York

Living with autism can present unique challenges, but there are numerous support services available in New York to assist individuals and families affected by autism. These services aim to provide resources, therapies, and specialized care to enhance the well-being and quality of life for those with autism.

Autism Resources in NY

New York offers a wealth of autism resources to help individuals and families navigate the challenges associated with autism. These resources include:

  • Autism Speaks - A leading advocacy organization that provides a comprehensive range of resources, including a 24/7 helpline, toolkits, and information on local services and support groups. You can learn more about Autism Speaks here.
  • New York State Department of Health - The New York State Department of Health offers information on autism services, early intervention programs, and resources for families. They provide guidance on accessing services and support through their website.
  • NYC Autism Charter School - The NYC Autism Charter School is dedicated to providing an inclusive and specialized education for students on the autism spectrum. They offer a supportive learning environment tailored to the unique needs of individuals with autism.

Therapies for Autism

Various therapies can help individuals with autism develop their skills, enhance communication, and improve overall functioning. In New York, several evidence-based therapies are available for individuals with autism, including:

  • Applied Behavior Analysis (ABA): ABA therapy focuses on teaching and reinforcing positive behaviors while reducing challenging behaviors. It is widely recognized as an effective therapy for individuals with autism.
  • Speech-Language Therapy: This therapy targets improving communication skills, including speech articulation, expressive and receptive language, social communication, and pragmatic language skills.
  • Occupational Therapy (OT): Occupational therapy helps individuals develop and improve skills needed for daily activities, such as self-care, fine motor skills, sensory processing, and social interaction.
  • Physical Therapy (PT): Physical therapy focuses on improving gross motor skills, coordination, balance, and strength. It can be beneficial for individuals with autism who may have motor challenges.
  • Social Skills Training: Social skills training aims to enhance social interactions, communication, and social understanding. It helps individuals with autism navigate social situations and develop meaningful relationships.

These therapies are often tailored to the specific needs of each individual with autism. The frequency and duration of therapy sessions may vary based on the individual's requirements.

Accessing these resources and therapies can significantly contribute to the overall well-being and development of individuals with autism in New York. It's essential to stay informed about available resources and work closely with healthcare professionals, educators, and support organizations to create a comprehensive support network for individuals and families living with autism.

Family Health Plus in NY

When it comes to accessing healthcare services for individuals with autism in New York, Family Health Plus (FHP) can be a valuable resource. FHP is a public health insurance program that provides comprehensive coverage to eligible individuals and families in the state of New York.

Eligibility Criteria

To be eligible for Family Health Plus in NY, individuals must meet certain criteria. Generally, eligibility is determined based on income, age, residency, and immigration status. The specific requirements may vary, and it is advisable to check the official website or contact the New York State Department of Health for the most up-to-date information.

Benefits Covered

Family Health Plus offers a wide range of benefits to eligible individuals, including coverage for essential health services related to autism. While the exact coverage may differ depending on the plan and individual circumstances, the following are some common benefits covered by Family Health Plus:

It is important to note that coverage and benefits can vary based on individual plans and specific needs. It is recommended to review the plan details and consult with the insurance provider for a complete understanding of the benefits available.

Family Health Plus in NY can be a valuable resource for families seeking healthcare coverage for their loved ones with autism. By meeting the eligibility criteria and accessing the benefits provided, families can ensure that their children receive the necessary medical services and support to thrive.

Financial Assistance Options

When it comes to managing the costs associated with autism, there are financial assistance options available in New York. Two key programs that provide support are Medicaid for Autism and SSI Benefits.

Medicaid for Autism

Medicaid is a government-funded healthcare program that provides medical coverage to individuals and families with limited income and resources. In New York, Medicaid offers coverage for autism-related services, including diagnosis, therapies, and other necessary treatments.

To be eligible for Medicaid for Autism, individuals must meet specific income and resource requirements. The income eligibility thresholds vary based on factors such as family size and income type. It's important to note that Medicaid is available to both children and adults with autism, ensuring that individuals can receive the necessary support throughout their lives.

SSI Benefits

Supplemental Security Income (SSI) is a federal program that provides financial assistance to individuals with disabilities who have limited income and resources. SSI benefits can help individuals with autism and their families by providing monthly cash payments to cover basic needs such as food, shelter, and clothing.

To qualify for SSI benefits, individuals must meet certain criteria, including having a disability that significantly impairs their ability to function and meet the program's income and resource limits. SSI benefits are available to both children and adults with autism, providing ongoing financial support.

It's important to note that eligibility criteria and benefit amounts for Medicaid for Autism and SSI Benefits can vary based on individual circumstances. It's advisable to consult with the relevant agencies or seek assistance from professionals who specialize in autism services to determine the specific eligibility requirements and benefits available.

By exploring these financial assistance options, families in New York can access the necessary support to manage the costs associated with autism. Medicaid for Autism and SSI Benefits provide essential resources to ensure individuals with autism can receive the care and services they need for their overall well-being.

Accessing Educational Support

When it comes to supporting children with autism, accessing educational support is crucial for their development and success. In New York, there are specific programs and plans in place to ensure that children with autism receive the necessary educational support. Two key components of this support are special education programs and Individualized Education Plans (IEPs).

Special Education Programs

Special education programs are designed to cater to the unique needs of children with autism and other disabilities. These programs provide individualized instruction and support to help children reach their full potential. Special education programs in New York offer a range of services, including:

  • Modified curriculum: The curriculum is tailored to accommodate the learning needs of children with autism, focusing on their strengths and addressing any challenges they may face.
  • Individualized instruction: Teachers and support staff work closely with each child, providing personalized instruction to meet their specific learning goals.
  • Behavioral support: Special education programs often incorporate behavioral interventions and strategies to address challenging behaviors and promote positive social interactions.

The goal of special education programs is to create an inclusive and supportive learning environment where children with autism can thrive academically, socially, and emotionally.

Individualized Education Plan (IEP)

An Individualized Education Plan (IEP) is a legal document that outlines the specific educational goals and support services for a child with autism. The IEP is developed collaboratively by a team that typically includes parents, teachers, special education professionals, and other relevant individuals.

The IEP includes:

  • Present levels of performance: This section provides a detailed assessment of the child's current abilities and challenges, helping to identify their specific educational needs.
  • Measurable goals and objectives: Goals are set for the child's academic, social, and behavioral development. These goals are specific, measurable, achievable, relevant, and time-bound (SMART).
  • Special education services: The IEP outlines the support services and accommodations that will be provided to the child, such as specialized instruction, occupational therapy, speech therapy, or assistive technology.
  • Related services: In addition to special education services, related services may also be included in the IEP. These services can include counseling, transportation, and other supports necessary for the child's success.
  • Transition planning: As children with autism grow and progress through different stages of education, the IEP includes transition planning to ensure a smooth transition to higher grade levels or post-secondary education.

The IEP serves as a roadmap for the child's education, ensuring that their unique needs are met and appropriate support is provided throughout their educational journey.

By accessing special education programs and developing an IEP, parents and educators can work together to create a supportive learning environment that maximizes the potential of children with autism and helps them thrive academically and socially.

Community Involvement and Advocacy

When it comes to autism, community involvement and advocacy play a crucial role in supporting individuals and families affected by this condition. By connecting with others who share similar experiences, individuals with autism and their families can find support, resources, and a sense of belonging. In New York, there are various support groups and advocacy organizations dedicated to autism.

Support Groups for Autism

Support groups provide a safe and understanding environment where individuals and families affected by autism can come together to share their experiences, seek guidance, and offer support to one another. These groups often consist of parents, caregivers, individuals with autism, and professionals who work in the field. They offer a valuable opportunity for individuals to connect, learn from each other, and access a network of support.

Here are a few support groups for autism in New York:

Advocacy Organizations

Advocacy organizations play a vital role in raising awareness about autism, promoting acceptance and inclusion, and advocating for the rights and needs of individuals with autism. These organizations work towards creating a more inclusive society, improving access to services and support, and influencing policies that impact individuals with autism and their families.

Here are a few advocacy organizations in New York:

By actively participating in support groups and connecting with advocacy organizations, individuals and families affected by autism can access invaluable resources, find a sense of community, and contribute to the broader advocacy efforts for autism awareness and acceptance in New York.


[1]: https://www.autismspeaks.org/

[2]: https://www.health.ny.gov/health_care/family_health_plus/

[3]: https://www.medicaid.gov/medicaid/benefits/autism-services/index.html

[4]: https://www.ssa.gov/pubs/EN-05-11069.pdf

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