Insurance Resource Center for Autism and Behavioral Health

15/10/2026

15/10/2026

ASK THE INSURANCE GURU:

"Dear Guru,

I have had MassHealth with Premium Assistance for the last 3 years. For 2027, my employer is offering only high-deductible plans with an HRA. I am afraid that the high deductible will cause me to lose Premium Assistance, but someone told me that an HRA (or similar benefit) can sometimes be used to help a plan meet the deductible requirements. The 2027 in-network family deductible on my new plan will be $9500. I am responsible for the first $4K of the family deductible. The HRA pays the next $5.5K. After the HRA pays off the amount it owes toward the deductible, my plan becomes a $2K individual/$4K family in-network deductible plan.

Will this plan be eligible for Premium Assistance next year?

Concerned Mom"

Dear Concerned Mom,

To be eligible for premium assistance, a health plan’s in-network deductible cannot exceed $3200 for an individual and $6400 for a family. You heard correctly that a high-deductible plan with an HRA can sometimes qualify for Premium Assistance, if certain things are true. As long as the HRA directly pays the balance due on both the individual and family deductible, and this results in the in-network deductible not exceeding the $3200 Individual/$6400 Family maximum, your plan will most likely be eligible for Premium Assistance in 2027. However, if you paid the balance due and submitted for reimbursement from the HRA, it would not be eligible.

In your case, your employer plan will likely be eligible for Premium Assistance in 2027 since the HRA is the entity paying the provider directly for the balance due! It is important to remember there are other requirements for Premium Assistance eligibility, and you can always call Accenture (MassHealth’s Premium Assistance Vendor) at (800) 862-4840 if you have questions.

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.

14/10/2026

🎉 WEEKLY UPDATE! 🎉

We have just over one week to go! We have currently raised $10,859! 💙 We are so incredibly grateful for everyone who has donated, shared our posts, and supported the Insurance Resource Center Gurus! THANK YOU!!! 🙌💙

We’re getting close to our $15,000 goal, but we still need your help to get there. Every donation, big or small, makes a difference!
💙 Help us reach our goal!
👉 https://runsignup.com/Race/186352/Donate/lU8OWV8KG8zS8YgX
Let’s see if we can hit that $15,000 mark! 🏃‍♀️🏃‍♂️💙

13/10/2026

https://umassmed.zoom.us/meeting/register/Gj4c4KNKRbmEDvqVP8eB0w

08/10/2026

Dear Guru Readers,

We have an incredible opportunity to come together as a community and make a difference!

The Insurance Resource Center for Autism and Behavioral Health (IRC) provides guidance to individuals and families, navigating the often-overwhelming world of health insurance. Best of all, they provide their services completely free of charge to those who reach out to them.
One of the ways the IRC is able to continue this vital work is through its charity partnership with the annual Doug Flutie Jr. Foundation for Autism 5K. Which is happening just in a couple of weeks on Sunday, October 26, in Natick, Massachusetts, and we would be grateful if you would consider donating to our team!

Every dollar donated to the IRC goes directly toward helping families access healthcare, maintain critical coverage, and overcome barriers that can stand between them and the services they depend on. Your participation doesn't just support an organization it supports real people, real families, and real futures.

Together, we can celebrate our community, raise awareness, and make a meaningful impact. We can't do this without you.

Donate here: https://runsignup.com/ircgurus

07/10/2026

🎉 WEEKLY UPDATE! 🎉

We did it—we’ve officially raised over $10,000 for our team! 💙 We are so incredibly grateful for everyone who has donated, shared our posts, and supported the Insurance Resource Center Gurus!

THANK YOU!!! 🙌💙

We have just over two weeks left, and we’re hoping to reach our $15,000 goal! We’re getting close, but we still need your help to get there. Every donation, big or small, makes a difference!

💙 Help us reach our goal!
👉 https://runsignup.com/Race/186352/Donate/lU8OWV8KG8zS8YgX

Let’s see if we can hit that $15,000 mark! 🏃‍♀️🏃‍♂️💙

01/10/2026

Attention MassHealth Standard Members:

01/10/2026

ASK THE INSURANCE GURU:

"Hello Guru,

I received a MassHealth renewal for my daughter. I updated the information online and provided MassHealth with recent pay stubs for both myself and my husband.

Does this take care of my annual MassHealth renewal and Premium Assistance?

Jennifer"

Dear Jennifer,

The MassHealth renewal and premium assistance renewal are two different annual renewals. You did a great job of renewing your daughter’s MassHealth. But this will not automatically renew your premium assistance. Premium Assistance must be renewed annually after you pick a plan, or roll over your current health plan during your employer’s open enrollment period. For example, if your employer's open enrollment is coming up this October for 2027 plans, you need to submit a premium assistance review form in late October or by mid-November.

This is to ensure you receive a premium assistance check in December to cover the January premium. Premium Assistance pays one month in advance. The last premium payment checks will be mailed in November to cover the December premium. This is why it is important that you do not delay submitting the review form and 2027 plan summary of benefits.

Here’s a link to the Premium Assistance review form: https://www.mass.gov/doc/premium-assistance-compliance-form/download

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.

30/09/2026

This presentation has been canceled and will be postponed to Thursday November 5th instead.

Canceled.

30/09/2026

The Insurance Resource Center Gurus are getting ready to hit the pavement at the Flutie 5K on Sunday, October 25th, at Natick High School — and we need YOUR support! 🎉A HUGE thank you to everyone who has donated and supported the Insurance Resource Center for Autism & Behavioral Health. Your generosity helps us continue providing information, resources, and support to families, providers, and others navigating insurance questions.

We’re excited to share that we’ve already raised $8,979 toward our $15,000 goal! 🙌 Thank you so much ❤️

💙 Donate today and support the Insurance Resource Center!
👉 Click the link below to make a donation.
https://runsignup.com/Race/186352/Donate/lU8OWV8KG8zS8YgX