Florida Medicaid Autism Coverage
Florida Medicaid covers ABA through age 21 via EPSDT, but the commercial insurance mandate caps coverage at $36,000/year through age 18. The iBudget waiver funds long-term services but has a years-long waitlist.
Quick Answer
Florida Medicaid covers ABA through age 21 via EPSDT, but the commercial insurance mandate caps coverage at $36,000/year through age 18. The iBudget waiver funds long-term services but has a years-long waitlist.
- ABA benefit: covered under EPSDT for under 21 (via epsdt).
- HCBS waivers: 1 relevant waiver option listed on this page.
- Commercial insurance: Florida has a state autism insurance mandate.
Medicaid ABA Coverage
Yes — EPSDT
Under 21 (via EPSDT)
Insurance Mandate
Yes
$36,000/year (aggregate cap through age 18)
HCBS Waivers
1 available
Waitlist: 5–10+ years
About this information
This page summarizes public Medicaid, waiver, and insurance-mandate information for general reference.
Medicaid benefits, managed-care rules, and waiver waitlists can change quickly, so families should verify eligibility, prior authorization, and enrollment steps with the administering agency before relying on this page.
Last reviewed 2026-04-21 by Autism Hearts Editorial Team
Florida Commercial Insurance Mandate
- Statute
- Florida Statute § 627.6686 / § 641.31098
- Year enacted
- 2008
- Age limit
- Through age 18
- Annual cap
- $36,000/year (aggregate cap through age 18)
Covered services
Self-funded employer plans (often from large employers) are regulated by federal ERISA law, not state mandates, and may be exempt. Always confirm your plan type on your Summary of Benefits and Coverage.
Medicaid ABA Therapy Benefit
- Covers ABA
- Yes
- Age limit
- Under 21 (via EPSDT)
- Prior auth required
- Yes
Florida Medicaid covers Behavior Analysis services via managed care plans.
Florida HCBS Waivers
iBudget Florida Waiver
Covers autismIDD individuals on APD wait list
- Waitlist:
- 5–10+ years
- Apply via:
- APD regional office
Katie Beckett / TEFRA Option
Available — Florida Model Waiver (limited slots)
Very limited capacity; most families qualify via APD/iBudget instead.
Early Intervention (Birth–3)
Early Steps — Florida's IDEA Part C program. Children under 3 with developmental delays can access services without a formal autism diagnosis.
Official Sources
Use these primary sources when you need to confirm current Medicaid rules, waiver access, or state-agency guidance in Florida.