What is the income limit for the Rhode Island autism waiver in 2025?

The income limit is generally 250% of the Federal Poverty Level (FPL). For a family of four, that is about $80,000 per year in gross income. However, this number can change annually, so check with the Rhode Island Executive Office of Health and Human Services for the most current figures.

Can I get the waiver if my income is over the limit?

Yes, you may still qualify through the Katie Beckett waiver (which uses the child's income only) or a spend-down program. The spend-down requires you to pay a portion of your income toward medical expenses before Medicaid covers the rest.

Does the waiver cover ABA therapy?

Yes, the waiver covers Applied Behavior Analysis (ABA) therapy, along with speech, occupational, and physical therapy. Services are provided by BCBA-led providers and can be done at home, in the community, or in a clinic.

How long does it take to get approved for the waiver?

The process can take several months, from application to approval. There may also be a waiting list for waiver slots. It is best to apply as soon as your child is diagnosed to start the process early.

Do I need to have a formal autism diagnosis?

Yes, a formal diagnosis of Autism Spectrum Disorder (ASD) from a qualified professional, such as a developmental pediatrician or psychologist, is required. The diagnosis must be current and documented.

Can your free service help me find a provider after I get the waiver?

Absolutely. Once you have waiver approval, our free matching service can connect you with vetted, BCBA-led ABA therapy providers in Rhode Island who accept Medicaid. We simplify the search so you can focus on your child's care.

Rhode Island Autism Waiver Income Limits: 2025 Guide

In short: Rhode Island's autism waiver (the Home and Community-Based Services Waiver for Children with Autism Spectrum Disorder) has specific income limits that are tied to the state's Medicaid eligibility. Generally, families must meet income requirements at or below 250% of the Federal Poverty Level (FPL) for children under 19. However, there are pathways like Katie Beckett or spend-down options if you exceed these limits. The waiver covers ABA therapy, and our free service can match you with vetted, BCBA-led providers who accept Medicaid.

What Is the Rhode Island Autism Waiver?

The Rhode Island autism waiver, officially called the Home and Community-Based Services (HCBS) Waiver for Children with Autism Spectrum Disorder (ASD), is a Medicaid program that helps families pay for essential therapies and supports for children with autism. This includes Applied Behavior Analysis (ABA) therapy, which is often recommended by pediatricians and BCBAs. The waiver is designed to keep children in their homes and communities rather than in institutional settings.

Our free service, ABA For My Child, is not a provider but a matching service. We help you find vetted, BCBA-led ABA therapy providers who accept the waiver and Medicaid. This means you can focus on your child's care without worrying about the financial burden.

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🔗 Related reading: California Medicaid Waivers for Autism: A Complete Guide · Local ABA Therapy

Rhode Island Autism Waiver Income Limits: The Basics

Income limits for the Rhode Island autism waiver are based on the Federal Poverty Level (FPL). As of 2025, the limit for most children under 19 is 250% of the FPL. Here is a quick breakdown of what that means for a family of four:

250% FPL (2025 estimate): For a family of four, this is approximately $80,000 per year in gross income.
For smaller families: A family of three is around $66,000, and a family of two is about $52,000.
Important: These numbers are adjusted annually. Always check with the Rhode Island Executive Office of Health and Human Services (EOHHS) for the most current figures.

If your income is below these limits, your child may qualify for the waiver. If it is above, do not lose hope-there are other options.

How Income Is Counted

When determining eligibility, Rhode Island considers the child's income and the household income. However, the waiver uses a categorically needy standard, meaning the child's own income is counted first. In most cases, children under 18 have little to no income, so the household income is what matters. The state looks at gross income before taxes, but certain deductions may apply (e.g., child care costs, medical expenses).

What If Your Income Exceeds the Limit?

If your family's income is above 250% FPL, you are not automatically disqualified. Rhode Island offers two main pathways:

Katie Beckett Waiver

The Katie Beckett waiver (officially the Tax Equity and Fiscal Responsibility Act or TEFRA option) allows children with significant disabilities to qualify for Medicaid based on their own income and assets, not the parents' income. This means if your child's personal income is low (which it usually is), they can get Medicaid coverage even if you earn a high salary. This waiver is separate from the autism waiver but can be used to access ABA therapy through Medicaid.

Spend-Down Program

If your income is above the limit, you may qualify for a spend-down. This means you pay a portion of your income toward medical expenses each month before Medicaid kicks in. For example, if your income is $1,000 over the limit, you might have to pay $1,000 in medical costs (like therapy co-pays) before the waiver covers the rest. This can be complex, so it is wise to consult with a Medicaid planner or social worker.

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🔗 Related reading: NY Medicaid ABA Waiver Requirements Explained · Nearby ABA Therapy

How to Apply for the Rhode Island Autism Waiver

Applying for the waiver involves several steps. Here is a general guide:

Step 1: Contact the Rhode Island Executive Office of Health and Human Services (EOHHS) or your local Department of Human Services (DHS) office. You can call 1-855-697-4347 for assistance.
Step 2: Gather documentation, including proof of income (tax returns, pay stubs), your child's autism diagnosis (from a doctor or psychologist), and proof of residency.
Step 3: Complete the Medicaid application. You can do this online at the RI Bridges portal (https://www.ribridges.ri.gov).
Step 4: If approved for Medicaid, request a waiver slot. There may be a waiting list, so apply as early as possible.
Step 5: Once approved, you can choose a provider. Our free service can help match you with BCBA-led ABA providers who accept the waiver.

What Does the Waiver Cover?

The Rhode Island autism waiver covers a range of services, including:

ABA therapy: One-on-one sessions with a Board Certified Behavior Analyst (BCBA) or a registered behavior technician (RBT) under supervision.
Speech-language pathology: For communication challenges.
Occupational therapy: For daily living skills and sensory issues.
Physical therapy: If needed for motor skills.
Respite care: Temporary relief for caregivers.
Parent training: To help you support your child's progress.

Most services are provided in your home, community, or a clinic setting. The waiver is designed to be flexible to meet your child's unique needs.

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Costs and Insurance: What You Pay

One of the biggest benefits of the waiver is that it covers the cost of therapy with no out-of-pocket expenses for families who qualify. Medicaid pays the provider directly. There are no premiums or co-pays for waiver services. However, if you use a spend-down, you may have to pay a monthly amount before coverage starts.

If your child has private insurance, the waiver can act as a secondary payer, covering what insurance does not. This is often called wrap-around coverage. For example, if your insurance covers 20 hours of ABA per week, the waiver might cover additional hours or co-pays.

Practical Tips for Families

Navigating the waiver process can feel overwhelming, but these tips can help:

Start early: The application process can take months, and there may be a waiting list for waiver slots. Apply as soon as your child is diagnosed.
Keep records: Save all paperwork, including diagnosis letters, income documents, and correspondence with EOHHS.
Ask for help: Contact a Family Service Coordinator through Rhode Island's Early Intervention program (for children under 3) or your local school district (for children 3 and up). They can guide you.
Use our free matching service: Once you have waiver approval, we can connect you with BCBA-led providers who specialize in ABA therapy and accept Medicaid. This saves you time and stress.
Reapply annually: Medicaid eligibility is reviewed each year. Make sure to update your income information promptly.

Common Mistakes to Avoid

Assuming you make too much: Many families think they are over the limit but qualify through Katie Beckett or spend-down. Always apply.
Waiting for a slot without applying: Even if there is a waiting list, you need to be on it. Do not delay.
Not documenting the diagnosis: A formal autism diagnosis from a qualified professional is required. Make sure it is current.

Frequently Asked Questions

We have included a separate FAQ section below to address common questions about income limits and the waiver process.

Rhode Island Autism Waiver Income Limits: What Families Need to Know

Key takeaways

What Is the Rhode Island Autism Waiver?