Insurance Resource Center for Autism and Behavioral Health

ASK THE INSURANCE GURU:

“Dear Guru,

I remember you saying that we could reach out to you if we come across acronyms and don’t know what they stand for. Can you please provide a list of acronyms that I might see now that I decided to apply for MassHealth.”

I am so glad you asked. There are a lot of acronyms related to MassHealth coverage, but I will pick a few of my favorites that you might see while you are applying for coverage. If there is a specific acronym not shown here that you come across, just shoot me a quick email and I will reply. When I say that there are a lot of acronyms that you might see, I am not exaggerating!

ARD (Authorized Representative Designation Form): This is a form that needs to be completed to speak to MassHealth about someone other than yourself or your minor child(ren). It designates the person chosen to act on someone’s behalf.

DES (Disability Evaluation Services): MassHealth has contracted with Disability Evaluation Services to assist with disability evaluations and verify disabilities.

ESI (Employer Sponsored Insurance): Health insurance through your employer. If you have access to ESI, MassHealth needs to know about it. ESI that meets certain requirements can make you eligible for an additional benefit called Premium Assistance.

MAGI (Modified Adjusted Gross Income): When you apply for MassHealth coverage, they will look at your Modified Adjusted Gross Income as reported on your taxes for eligibility/ premium purposes.

Reminders:

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.

ASK THE INSURANCE GURU:

"Dear Guru,

My son was recently diagnosed with autism. I’m overwhelmed by trying to coordinate all the services, therapies, specialists, and insurance. Is there anyone who can help manage all of this?

Thank you,
Wanda Guidance"

Dear Wanda,

Many insurance companies offer case management or care coordination services that can help families of individuals with autism navigate care and services.

A case manager or care coordinator can help coordinate appointments, connect families with in-network providers, explain benefits and coverage, assist with prior authorizations, and help identify community resources and supports. They can also help families understand how different services work together — from ABA and speech therapy to medical specialists and behavioral health care.

For families juggling multiple providers, long waitlists, and complex insurance rules, having a case manager can make the process feel less overwhelming and help improve communication across the care team.

If you or your child has autism and you’re unsure what support your insurance offers, call the member services number on your insurance card and ask whether case management or care coordination services are available.

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.