Autism spectrum disorder (ASD) and autism are both general terms for a group of complex disorders of brain development. These disorders are characterized, in varying degrees, by difficulties in social interaction, verbal and nonverbal communication and repetitive behaviors.

ASD can be associated with developmental disability, difficulties in motor coordination and attention and physical health issues such as sleep and gastrointestinal disturbances. Some persons with ASD excel in visual skills, music, math and art.
Eligibility for autism services is verified by the Bureau of Autism Services. County MH/ID offices verify eligibility only when the individual’s diagnosis qualifies them for developmental disability. Many counties in Pennsylvania oversee the contracts with behavioral health managed care organizations who provide Medical Assistance coverage for behavioral services that some individuals with autism need to receive. This means counties help assure the availability of qualified providers to offer needed services, and monitor for quality in service delivery.
Pennsylvania has an autism insurance act which requires private health insurance companies to cover the cost of diagnostic assessment and treatment of autism spectrum disorder and services for children and young adults under the age of 21. Insurance companies are required to cover up to $36,000 per year in costs, and if costs exceed this amount, the individual can be covered by Medical Assistance.
Children and young adults under the age of 21 with autism who do not have private insurance, but are eligible for Medical Assistance, also receive coverage for services to assess and treat ASD through PA’s Medicaid managed care program for physical and behavioral health, known as HealthChoices.
The Bureau of Autism Services in ODP also administers two programs for adults with autism, the Adult Autism Waiver (AAW) and the Adult Community Autism Program (ACAP). A comparison of the AAW and ACAP is available here. The goal of these programs is to help adults with autism participate in their communities the way they want to.
Pennsylvania also has an Autism Services Education, Resource and Training (ASERT) collaborative to support individuals with autism and their families. All ASERT resources can be accessed at This site includes information about local, regional and statewide events, professional trainings, community resources, services, current research and other information relevant to the autism community.
Persons interested in more information regarding eligibility for autism services may call 1-877-231-4244 for more information.

Financial eligibility determinations for Medical Assistance are made through the Department of Public Welfare’s County Assistance Offices. Applications for financial eligibility can be done in person or online.