Financing autism therapy: who pays, who is responsible?

Legal status: 09.10.2026 (federal law, checked against the statutory text). This article only explains benefits of integration assistance, youth welfare and early intervention. Benefits of the health insurer (for example remedies or psychotherapy) are not covered here and have not been checked. Legal terms are translated here for understanding; the German wording of the law is what counts.

Before school entry: early intervention and curative education services

Early intervention is aimed at children with disabilities and at children at risk of a disability, from birth until school entry. It comprises medical and non-medical services and is provided together with curative education services as a complex service. ^{[2; 3]} Curative education services come into question for children not yet in school. ^[3] More: Early intervention for autism.

Children and adolescents: the youth welfare office

Children and adolescents with a mental disability or an impending mental disability are entitled to integration assistance under section 35a SGB VIII. The provider of public youth welfare, the youth welfare office, is responsible; for this it needs the opinion of a professional. ^[6] The task, goals and type of benefits follow SGB IX as far as it is applicable. ^[6] For young people with a physical or intellectual disability, under section 10 para. 4 SGB VIII integration assistance under SGB IX takes precedence. ^[7] Which of these routes fits your child is a question for the individual case. Details: Section 35a SGB VIII.

Adults and other cases: integration assistance

The task of integration assistance is to enable a life that corresponds to human dignity and to promote full, effective and equal participation. ^[4] Benefits go to people with disabilities who are substantially restricted in equal participation or threatened by such a substantial disability. ^[5] More: Integration assistance under SGB IX.

How a registration can work (example)

The Marburg Institute for Autism Research and Therapy (Marburger Institut für Autismusforschung und Therapie) describes the process for its facility: the requirement is a diagnosis at a facility specialised in autism and a recommendation for autism-specific therapy. This is followed by a first phone call on the therapy goals, an application for cost coverage, approval by the responsible cost provider and only then the start of treatment. ^[8] This applies to this facility; other services may differ. The page does not state waiting times and costs.

Important for applications

• Clarify responsibility: For participation benefits, the provider where you apply checks within two weeks of receiving the application whether it is responsible, and otherwise forwards the application. ^[1] More: Applying and filing an objection.
• Have it approved before starting: Do not start a therapy at your own expense before you have clarified with the facility and the cost provider how the costs are handled (suggestion from the editorial team; self-procurement is not covered here).
• Get independent advice: Finding independent advice: what the EUTB does.
• In the case of a rejection notice: observe the objection deadline (see Applying and filing an objection).

What this article does not explain

Not covered are benefits of statutory health insurance, costs of aids, own contributions and the counting of income and assets, self-procurement of benefits and rules of individual states and municipalities. A reform of responsibility for children and adolescents with disabilities (youth welfare office for all) is in preparation as a draft and is not yet law.

Sources and literature

1. § 14 SGB IX – Leistender Rehabilitationsträger (www.gesetze-im-internet.de/sgb_9_2018/__14.html). – Statute (German federal law, in German)
2. § 46 SGB IX – Früherkennung und Frühförderung (www.gesetze-im-internet.de/sgb_9_2018/__46.html). – Statute (German federal law, in German)
3. § 79 SGB IX – Heilpädagogische Leistungen (www.gesetze-im-internet.de/sgb_9_2018/__79.html). – Statute (German federal law, in German)
4. § 90 SGB IX – Aufgabe der Eingliederungshilfe (www.gesetze-im-internet.de/sgb_9_2018/__90.html). – Statute (German federal law, in German)
5. § 99 SGB IX – Leistungsberechtigter Personenkreis (www.gesetze-im-internet.de/sgb_9_2018/__99.html). – Statute (German federal law, in German)
6. § 35a SGB VIII – Eingliederungshilfe für Kinder und Jugendliche mit seelischer Behinderung oder drohender seelischer Behinderung (www.gesetze-im-internet.de/sgb_8/__35a.html). – Statute (German federal law, in German)
7. § 10 SGB VIII – Verhältnis zu anderen Leistungen und Verpflichtungen (www.gesetze-im-internet.de/sgb_8/__10.html). – Statute (German federal law, in German)
8. Universitätsklinikum Marburg, Marburger Institut für Autismusforschung und Therapie (MarIAT): Seite „Anmeldung“. https://www.uni-marburg.de/de/fb20/bereiche/zpg/mariat/anmeldung – Facility website (example; in German)