How long is the Medicaid waiver waiting list?

It depends entirely on the state, and the range is enormous — from no formal waiting list in a few states to more than a decade in others. Because most states rank by application date, the single most useful thing a family can do is apply as early as possible, even before they are sure they need services.

Should I apply for a waiver before I need it?

It depends which system your state runs, and this is where most advice goes wrong. In first-come states such as Texas and Kentucky, yes — apply immediately, because your date is your place. In needs-scored states such as Maryland and Louisiana, an early date helps far less than a thorough assessment interview. In states with no queue at all, such as Wisconsin, there is no place to bank and applying early achieves nothing. And in Massachusetts there is no rolling application at all — the state opens a request window and closes it again.

Do I earn too much for a Medicaid waiver?

Probably not, and this assumption stops more families than any rule does. Many waivers assess the child's income and resources rather than the household's, so parental earnings are disregarded. Separately, TEFRA/Katie Beckett programs exist specifically to waive parental income — Idaho's is open to children of all incomes. Apply anyway, and ask your state whether it has a Katie Beckett or TEFRA route. Where a resource limit applies to the child, such as Delaware's $2,000 cap, an ABLE account or a special needs trust may change what counts.

Is a Medicaid waiver how I get ABA therapy?

Often not. Autism-specific waivers have been closing, because federal regulators have directed states to cover behavioral therapy through ordinary state-plan Medicaid under the EPSDT benefit for under-21s instead. That is usually better: EPSDT is an entitlement with no waiting list, whereas a waiver is capped and queued. Colorado and South Carolina both closed autism waivers on this basis. If your immediate need is ABA for a child on Medicaid, ask the health plan about EPSDT rather than joining a waiver queue — and apply for the waiver in parallel for the things EPSDT does not cover, such as respite and personal care.

Medicaid waivers

Medicaid waivers for autism, state by state

Q: What is a Medicaid waiver, and why does autism qualify?

A Home and Community-Based Services (HCBS) waiver lets Medicaid pay for support at home and in the community — respite, therapies, personal care, day programs — instead of only in an institution. Most states reach autistic people through a developmental-disability waiver rather than an autism-specific one, and many waive the parents' income from the eligibility calculation, so families who don't qualify for regular Medicaid often still qualify here.

Q: Can my child qualify for a Medicaid waiver if they don't have an intellectual disability?

It depends on the state, and this is one of the cruellest variations in the system. Some states reach autistic people only through an intellectual disability route — Alabama's main waiver requires a tested IQ below 70, and Oklahoma's standard route asks for a primary intellectual disability diagnosis — so a verbal, capable autistic person with serious support needs can be excluded by definition rather than by queue position. Other states do the opposite: Connecticut runs a waiver requiring a Full Scale IQ of 70 or above, built specifically for autistic people who do not have an intellectual disability. If you are refused by one program, ask what other route exists in your state rather than treating it as a refusal by the state itself.

A Medicaid waiver is usually the largest single source of funding a family will ever access — respite, therapies, personal care, day programs. In most states the waiting list is measured in years, and your place in it is set by the day you apply.

Find out what to do in your state →

Five questions, nothing sent anywhere.

If you take one thing from this page: find out which of the five systems below your state uses, because the standard advice — apply early, wait your turn — is only correct in one of them. In the others it is useless, and in one of them it is actively misleading.

Five ways states decide who gets served

We have read the rules in all 51 of them — every state and the District of Columbia — in full. They do not run one system with different wait times. They run five genuinely different systems, and which one you are in changes what you should do this week.

First-come queue

e.g. Texas, Kentucky

Your place is set by the date you applied, and it does not move unless you do something to move it. These are the states where waits are measured in years and sometimes decades.

What to do: Apply today, before you know what services you want. This is the one system where the common advice is exactly right — every month you delay is a month added to the end of the line.

Needs-scored priority

e.g. Maryland, Louisiana

An assessment sorts you into a priority band, and someone in crisis who applied last month is served ahead of someone comfortable who applied a decade ago. Your date is recorded but it is not what moves you.

What to do: Applying early still matters, but the assessment interview is the moment that decides your position. Describe what actually goes wrong — not the version where you are coping. Ask which band you were placed in, and how to request a review.

No queue at all

e.g. Wisconsin, Colorado's children's waiver

The state funds everyone who qualifies, either as an entitlement or through continuous enrollment. The gate is eligibility, not time.

What to do: Do not apply years early to bank a place — there is no place to bank. Apply when you need services, and put your energy into meeting the eligibility criteria instead.

Crisis-only entry

e.g. Indiana's comprehensive waiver

There is no waiting list, which sounds like good news and is the opposite. Entry requires an emergency — loss of a caregiver, a caregiver over 80, serious risk of harm. A family that is coping receives nothing, and accrues no seniority while they cope.

What to do: Take whatever smaller waiver you can get now, and know the exact emergency criteria in advance so you can act the day your circumstances change. Keep documentation of the strain before it becomes a crisis.

Open-request window

e.g. Massachusetts

There is no rolling application at all. The state opens a request period, families apply inside that window, and it closes again. Miss it and there is nothing to join until the next one.

What to do: Find out when the next window opens and set a reminder now. This is the only system where being organized on one specific date matters more than anything else you do.

If what you need is ABA, you may be chasing the wrong program

Autism-specific waivers are disappearing, and the reason matters. When states tried to fund behavioral therapy through a waiver, federal regulators generally pushed back and directed them to cover it through ordinary state-plan Medicaid instead, under the benefit for under-21s known as EPSDT.

That is usually better news than it sounds. A waiver is a capped program with a queue. EPSDT is an entitlement — if a Medicaid-enrolled child under 21 needs a medically necessary service, the state has to cover it, and there is no waiting list to join. Colorado and South Carolina both closed autism waivers on exactly this basis.

So if your immediate need is ABA or speech or OT for a child on Medicaid, ask the health plan about EPSDT coverage rather than queueing for a waiver. The waiver is for the other things — respite, personal care, day services, home modifications — and those are worth applying for in parallel, not instead.

The same logic explains why some states have no queue at all. Oregon delivers in-home support through the K Plan and Idaho through its enhanced state plan — both state plan benefits rather than waivers, and state plan benefits cannot be capped at a fixed number of slots. In the District of Columbia the waiver does not serve children at all; they go through Medicaid and EPSDT.

Two things that stop families who would otherwise qualify

Being “too capable” to qualify

Several states reach autistic people only through an intellectual disability route. Alabama's main waiver requires a tested IQ below 70; Oklahoma's standard route asks for a primary intellectual disability diagnosis. A verbal, capable autistic person with serious support needs can be excluded by definition rather than by queue position — which is devastating to hear and easy to mistake for a personal failure.

What to do:a refusal from one program is not a refusal from the state. Ask what other route exists — Alabama's Community Waiver Program, Oklahoma's Adult Autism Waiver. Connecticut goes further and runs a waiver requiring an IQ of 70 or above, built specifically for this group. The program you need may exist under a name nobody mentioned.

Assuming you earn too much

Many families never apply because they assume their income disqualifies them. Often it does not. Waivers frequently assess the child rather than the household, and TEFRA/Katie Beckett programs disregard parental income entirely — Idaho's is open to children of all incomes.

What to do: apply anyway, and ask specifically whether your state has a Katie Beckett or TEFRA route. Where there is a resource limit — Delaware caps countable resources at $2,000 — an ABLE account or a special needs trust may change what counts.

Every state

Typical waits are as reported by each state or its parent organizations. They move, and they are estimates — always confirm with the agency.

State	Waiver program	Typical wait
AlabamaFull guide	Intellectual Disabilities (ID) Waiver, Living at Home Waiver and Community Waiver Program	VariesMulti-year on both established waivers
AlaskaFull guide	IDD Waiver, entered through the DD Registry	Varies721 on the registry with about 50 taken off a year — an implied 14+ years
ArizonaFull guide	DDD services through ALTCS	VariesNo separate waiting list — but you must clear two gates
ArkansasFull guide	Community and Employment Support (CES) Waiver	VariesYears — more than 4,500 people waiting, served strictly in date order
CaliforniaFull guide	Regional Center services under the Lanterman Act	VariesNo waiting list — services are an entitlement
ColoradoFull guide	Children's Extensive Support (CES) for children; HCBS-DD and Supported Living Services for adults	5–10 yearsNo state waitlist for CES; around 7 years for the adult DD waiver
ConnecticutFull guide	DSS Waiver for Persons with Autism, plus the DDS Individual and Family Supports Waiver	VariesAround 2,000 autistic people waiting; no general I/DD waiting list
DelawareFull guide	DDDS Lifespan Waiver	VariesNo waiting list
District Of ColumbiaFull guide	DDA HCBS Waiver (adults 18+); children use DC Medicaid with EPSDT	VariesA waiting list activated on 1 January 2026, sorted by need category
FloridaFull guide	iBudget Florida Waiver (APD)	VariesOften 10+ years — one of the longest in the country
GeorgiaFull guide	New Options (NOW) and Comprehensive Supports (COMP) Waivers	VariesNeeds-based, not date-based — position depends on assessed need
HawaiiFull guide	Medicaid I/DD Waiver	ShortestNo waitlist reported
IdahoFull guide	TEFRA/Katie Beckett, plus state plan HCBS through Children's DD Agencies	VariesNo waiting list reported
IllinoisFull guide	Illinois DD Waiver, accessed through PUNS	10+ years5–10 years — selection is by time spent in 'Seeking Services'
IndianaFull guide	Family Supports Waiver (FSW) and Community Integration and Habilitation Waiver (CIH)	VariesYears for FSW; CIH is crisis-entry only
IowaFull guide	Intellectual Disability, Children's Mental Health and Health & Disability waivers — moving to the HOME system	VariesYears — some applicants have been waiting since 2020
KansasFull guide	IDD Waiver and the separate Autism (AU) Waiver	VariesAbout nine years for the IDD waiver, with 4,320 waiting
KentuckyFull guide	Michelle P. Waiver (MPW) and Supports for Community Living (SCL)	10+ yearsCommonly reported at 8–10 years, with more than 13,000 waiting
LouisianaFull guide	New Opportunities Waiver (NOW), Children's Choice and Supports Waivers	VariesYears — but urgency of need outranks your date on the registry
MaineFull guide	Sections 21 and 29 — transitioning to the new Lifespan waiver	VariesSection 29's waiting list has ended; both are closing to new enrollment
MarylandFull guide	DDA Community Pathways Waiver	10+ years3–10 years, but your priority category matters more than your date
MassachusettsFull guide	DDS Children's Autism Waiver, and adult DDS supports	VariesChildren's Autism Waiver opens only in limited request periods
MichiganFull guide	Habilitation Supports Waiver (HSW)	VariesMulti-year; priority goes to crisis and institutional transition
MinnesotaFull guide	Developmental Disabilities (DD) Waiver and Community Access for Disability Inclusion (CADI)	VariesNo statewide queue, but county allocations create local delays
MississippiFull guide	Intellectual Disabilities/Developmental Disabilities (ID/DD) Waiver	VariesYears, with roughly 2,500 waiting — crisis cases are prioritized
MissouriFull guide	Comprehensive, MOCDD, Community Support and Partnership for Hope Waivers	VariesVaries by waiver and regional office
MontanaFull guide	0208 Comprehensive Waiver	VariesAbout seven years, with roughly 2,095 waiting
NebraskaFull guide	Autism Waiver, Comprehensive and Developmental Disabilities Adult Day waivers	ShortestNo waitlist — the registry was eliminated in June 2025
NevadaFull guide	Autism Treatment Assistance Program (ATAP), plus the ADSD Intellectual Disabilities waiver	VariesATAP has a waiting list; apply as soon as you have a diagnosis
New HampshireFull guide	NH Developmental Disabilities Waiver (with the Acquired Brain Disorder waiver)	ShortestNo waitlist reported
New JerseyFull guide	DDD Supports Program and Community Care Program	VariesSupports Program has no wait; Community Care Program does
New MexicoFull guide	Developmental Disabilities (DD) Waiver, Medically Fragile Waiver and Supports Waiver	10+ years10–12 years for the DD Waiver
New YorkFull guide	OPWDD Home and Community Based Services Waiver	VariesEligibility itself takes months; service waits vary by region
North CarolinaFull guide	NC Innovations Waiver	VariesTen years or longer — and slots are first come, first served
North DakotaFull guide	Autism Spectrum Disorder Waiver (ages 0–20) and the traditional IID/DD Waiver	VariesMinimal on the DD waiver; 52 waiting on the ASD waiver
OhioFull guide	DODD Individual Options (IO) and SELF Waivers	5–10 years2–5 years, varying by county board
OklahomaFull guide	Consolidated, Community Living, PFDS and Adult Autism Waivers	Varies7+ years, with over 11,000 waiting — but the state is actively clearing it
OregonFull guide	K Plan (Community First Choice) and ODDS waivers	ShortestNo waitlist for K Plan in-home services
PennsylvaniaFull guide	Consolidated, Community Living and P/FDS Waivers (ODP)	VariesVaries by county and urgency category
Rhode IslandFull guide	BHDDH Division of Developmental Disabilities services	ShortestNo waitlist reported
South CarolinaFull guide	Community Support Waiver and Intellectual Disability / Related Disabilities Waiver	VariesVaries — one phone call starts the process
South DakotaFull guide	CHOICES and Family Support 360 waivers	VariesGenerally served without a long queue; risk-based priority if a list forms
TennesseeFull guide	Employment and Community First (ECF) CHOICES	VariesAround 1,750 waiting — small by national standards
TexasFull guide	Home and Community-based Services (HCS) Waiver	10+ years10–13 years
UtahFull guide	DSPD Home and Community-Based Services Waiver	5–10 years3–7 years
VermontFull guide	Developmental Disabilities Services waiver programs	ShortestNo waitlist reported
VirginiaFull guide	DD Waivers — Community Living, Family & Individual Supports, Building Independence	VariesBy urgency, not by date — Priority 1 is served within about a year
WashingtonFull guide	DDA waivers — Basic Plus, Core, CIIBS, IFS, Community Protection	VariesUsually none — but enrolling in DDA is not the same as getting services
West VirginiaFull guide	Intellectual and/or Developmental Disabilities (I/DD) Waiver	VariesThree or more years, with 967 waiting and 125–175 slots a year
WisconsinFull guide	Children's Long-Term Support (CLTS) Waiver; Family Care and IRIS for adults	ShortestNo waitlist — continuous enrollment, roughly 70 days from eligibility
WyomingFull guide	Supports Waiver and Comprehensive Waiver	VariesOne to three years, with about 282 waiting

What a waiver actually is

Home and Community-Based Services waivers let Medicaid pay for support in your home and community rather than only in an institution. What they fund varies by state, but commonly includes respite care, behavioral supports, personal care, therapies, day programs and supported employment.

The part most families don't know: many waivers disregard parental income. A family well above the usual Medicaid threshold can still qualify, because eligibility is assessed on the child rather than the household. If you assumed you earn too much, check anyway.

Most states reach autistic people through a developmental disability waiver rather than an autism-specific one, and several require a diagnosis showing the condition began before age 18 or 22. A few states have closed their autism-specific waivers entirely and moved families onto a broader program.

How waivers and waitlists work →

The longer guide — eligibility, what to do while you wait, and what to ask your state agency.

Find local providers →

While you wait, see what is available in your county now.

Program names, application routes and typical waits are compiled from state agency sources and state parent organizations. Waiting lists change constantly and these figures are estimates — always confirm current details with the agency before making decisions. If you spot something out of date, tell us and we'll fix it.