Parents of autistic children often want to save for the future but worry that money in the wrong place could cost their child SSI or Medicaid later. Three tools come up again and again: an ABLE account, a 529 college savings plan, and a special needs trust. They are built for different jobs, and many families use more than one. This guide compares them on the points that matter most: who owns the money, how it affects SSI and Medicaid, what happens at death, contribution limits and flexibility. It uses IRS, Social Security Administration (SSA), ABLE United and Florida statute sources as of October 2026. It is general information, not tax, legal or financial advice. A tax professional and a Florida attorney who handles special needs planning should review your plan.
What is each tool for?
- ABLE account: a tax-advantaged account owned by the person with a disability, for "qualified disability expenses." In Florida the program is ABLE United, run by Florida ABLE, Inc. under section 1009.986, Florida Statutes, and section 529A of the Internal Revenue Code.
- 529 plan: a qualified tuition program, usually owned by a parent or grandparent, for a beneficiary's education expenses. Florida's are the Stanley G. Tate Florida Prepaid College Program (s. 1009.98) and the Florida College Savings Program (s. 1009.981), both run by the Florida Prepaid College Board.
- Special needs trust: a legal arrangement in which a trustee holds money for the person with a disability. If it meets SSA's rules, the money is not counted as the person's resource for SSI. See special needs trusts in Florida.
How do they compare?
| Feature | ABLE account (ABLE United) | 529 plan | Special needs trust |
|---|---|---|---|
| Who owns it | The person with the disability (the beneficiary) | Usually the parent or grandparent who opened it | The trust, managed by a trustee |
| Who can use it | Disability or blindness that began before age 46 (before 26 until January 1, 2026); Florida residency for ABLE United | Anyone named as beneficiary | Depends on the trust type; first-party trusts need a person who is disabled and under 65 |
| Yearly contribution limit | $20,000 in 2026 from all contributors combined; working beneficiaries may add more through ABLE to Work | No federal annual cap; contributions cannot exceed what is needed for the beneficiary's qualified education expenses, and each plan sets its own limit | No federal annual cap for a third-party trust |
| Maximum balance | $500,000 at ABLE United | Set by the plan | None set by federal law |
| SSI resource treatment | SSA excludes up to and including $100,000 of the balance | Counts as a resource of the owner; for a child under 18, a parent's 529 can be deemed to the child | Not a resource if it meets SSA's trust rules |
| Medicaid eligibility | Continues even if SSI is suspended because the ABLE balance is over $100,000 | Depends on whose resource it is | Depends on the trust type and how it is drafted; ask the attorney |
| What it can pay for | Qualified disability expenses: education, housing, transportation, health, therapy, assistive technology and more | Qualified education expenses; some K-12 expenses up to $20,000 a year | Whatever the trust terms allow, usually paid directly to vendors |
| At the beneficiary's death | Florida Medicaid may not file a recovery claim except as required by federal law; federal rules can allow other states to claim | Owner keeps control; can change the beneficiary to another family member | First-party and pooled trusts must repay Medicaid; third-party trusts do not under SSA's trust rules |
| Setup | Online; $25 to open, no maintenance fee | Through the plan | Drafted by an attorney |
How do they affect SSI and Medicaid?
ABLE
SSA's operations manual (POMS SI 01130.740) tells staff to "exclude up to and including $100,000 of the balance of funds in an ABLE account from the resources of the designated beneficiary." Above that, the excess counts. If only the ABLE excess pushes an SSI recipient over the resource limit, SSI is suspended rather than ended, and the person stays eligible for Medicaid. Housing paid from ABLE should be spent in the month withdrawn. ABLE United's FAQ says ABLE funds are generally disregarded for Medicaid eligibility, even above $100,000.
529 plan
POMS SI 01140.150 says funds in a 529 plan "are a countable resource to the individual who owns the account (e.g. a parent or grandparent)," because the owner can usually withdraw them. The beneficiary normally has no rights to the funds. That matters for a child applying for SSI before 18: SSA's example is a disabled child whose father owns a 529, where the field office deems the father's resources, including the 529, to the child to the extent they exceed the parental limit. Deeming from parents stops at 18. See SSI for children with autism in Florida.
Special needs trust
A trust drafted to meet SSA's rules is not counted as the beneficiary's resource. How the trustee spends matters too: cash to the beneficiary counts as income, while payments to vendors for things like therapy or education generally do not. Our special needs trust guide explains the three trust types.
What happens to the money when the beneficiary dies?
This is where the tools differ most, and where an attorney's advice matters.
- ABLE: section 1009.986(7) says remaining funds go first to qualified disability expenses, then to the estate or another ABLE account, and that "except as required by federal law, the state Medicaid program may not file a claim for Medicaid recovery of funds in an ABLE account." SSA's POMS describes the federal rule that allows states to be reimbursed for Medicaid after qualified expenses are paid. ABLE United's FAQ says Florida Medicaid generally may not file a claim, and suggests checking the law of any other state where the person received Medicaid.
- 529: the owner, not the beneficiary, controls the account. SSA's manual notes that the designated beneficiary can be changed to a member of the beneficiary's family. Ask a tax professional how the owner's plan documents handle a beneficiary's death.
- Special needs trust: first-party and pooled trusts must repay the state for Medicaid paid during the person's life, up to what remains. A third-party trust funded only with other people's money is not subject to that payback rule in SSA's trust guidance, and the remainder can go to other family members.
Can money move between them?
- 529 to ABLE: ABLE United says you can roll money from a 529 into the ABLE account of the 529's beneficiary or certain family members without penalty, and that rollovers "count toward the $20,000 maximum annual contribution limit." SSA's POMS notes these rollovers have been allowed since December 22, 2017.
- Trust to ABLE: ABLE United says a special needs trust can be used to fund an ABLE account, which lets a trustee give the beneficiary a controlled, flexible spending account.
- ABLE to ABLE: one rollover every 12 months from another state's program; a beneficiary can have only one ABLE account.
What about the FES-UA scholarship and Florida Prepaid?
Florida's Family Empowerment Scholarship for Students with Unique Abilities lets families use scholarship funds for approved purposes that include ABA and "contributions to the Stanley G. Tate Florida Prepaid College Program ... or the Florida College Savings Program ... for the benefit of the eligible student" (s. 1002.394(4)(b)6). There is a catch. Section 1002.394(5) says the scholarship account must be closed and remaining funds, including those Prepaid or Savings Program contributions, revert to the state after, among other things, any period of 3 consecutive years after high school completion during which the student is not enrolled in an eligible postsecondary institution or program, or 2 consecutive fiscal years of account inactivity. Weigh that before moving scholarship money into college savings for a child whose plans after high school are uncertain. See the FES-UA scholarship guide.
Can any of these pay for ABA therapy?
- ABLE: ABLE United lists therapy among the expenses ABLE funds can be used for. Families use it for deductibles, copays or self-pay sessions. Keep invoices and explanations of benefits.
- 529: IRS Topic 313 says that, in connection with a beneficiary's enrollment at a K-12 school, qualified expenses now include "educational therapies for students with disabilities provided by a licensed or accredited practitioner or provider, including occupational, behavioral, physical, and speech-language therapies," within a combined $20,000 a year from all of the beneficiary's 529 plans. Whether a specific ABA bill qualifies is a tax question for your tax professional.
- Special needs trust: SSA lists therapy among third-party payments that are generally not income to the beneficiary. The trust terms and the trustee decide.
A decision checklist
- Is your child's disability onset before 46, and do you live in Florida? If yes, ABLE United is available. Many families open one early, even with a small balance.
- Will your child likely apply for SSI at 18? Favor ABLE and a third-party trust for savings in your child's name. A parent-owned 529 is counted to the parent, and to the child before 18 through deeming.
- Do relatives want to leave larger sums or property? A third-party special needs trust can hold amounts above ABLE limits and non-cash assets.
- Is college or a postsecondary program a real possibility? A 529 owned by a parent or grandparent can make sense, with a rollover to ABLE as a back-up within the annual limit.
- Is your child receiving a settlement or inheritance in their own name? Talk to an attorney about a first-party or pooled trust, and about ABLE.
- Who will manage the money later? Name a successor trustee and think about who will be the ABLE account's authorized legal representative when your child turns 18; see turning 18 in Florida.
Example only, not a recommendation: a family might keep an ABLE account for near-term therapy copays and equipment, write a third-party special needs trust into their wills for long-term support, and leave a grandparent's existing 529 in place in case their child attends a postsecondary program.
How Hope Center can help
Hope Center for Behavior Change provides ABA, parent training and mental health therapy. We do not give tax, legal or financial advice, but we can help you understand what ABA will cost so you can plan. We accept Florida Blue, Aetna, Cigna, UMR, Personify Health and TRICARE East, and offer self-pay for all services with a sliding scale. If your child has Medicaid, center policy does not allow self-pay at Hope Center; you can add marketplace or employer insurance, which we accept, and the sliding scale can help with your share. Start with a free benefits check, contact us, or call 561-337-8865. For step-by-step ABLE enrollment, see opening an ABLE United account.