Funding Options
There are many funding
options for
AAC
devices and services. It is important to review all applicable
options and combine options where appropriate.Funding for the Initial
AAC
Evaluation: A formal
AAC
evaluation is usually required by the various funding agencies.
Private Insurance: Many
private insurance carriers will fund an
AAC
evaluation. Prior authorization may be required. The specifics
of what is needed (e.g., multidisciplinary report, prescription,
invoice) will depend on your particular policy coverage. Your
policy handbook should be your guide to understanding your
covered services. It is likely that your private insurance
company will be unfamiliar with
AAC.
Insurance companies tend to deny coverage if they do not
perceive the evaluation as a “covered service.” You may need to
justify the evaluation as a medically necessary service before
your private insurance agency will provide coverage.
Schools: Schools are
required by law to provide appropriate assistive technology
services. This can include augmentative devices, printers and
computers that are necessary for your child to actively
participate in class and to complete homework assignments. If
your child’s school does not have qualified service providers on
staff to perform an evaluation, an outside evaluation should be
conducted at the school’s expense. The requirement for an
AAC
evaluation and the needed intervention services to facilitate
the development of effective communication skills must be
written into your child’s Individual Education Plan (IEP).
Medicaid: If your child has Medicaid
coverage, ask an evaluation team if they accept Medicaid
reimbursement for their services.
Division of Vocational
Rehabilitation: Services through
VR
are typically tied directly to a plan of action that has been
developed by an individual with their
VR
counselor for the purpose of seeking employment. If use of
AAC
is required in order to accomplish established objectives,
funding for the evaluation will probably need to be arranged by
VR
in collaboration with the evaluation agency.
Funding for the Recommended Equipment or Device
Private Insurance:
Private insurance carriers are beginning to fund
AAC
equipment. Prior authorization will usually be required.
Coverage depends on what is listed in your policy. Your policy
handbook should be your guide to determining what services or
equipment are covered. It is likely that your private insurance
company will be unfamiliar with
AAC.
They may tend to deny coverage if they do not see how the
equipment being requested corresponds to the “covered services”
listed in your handbook. You may need to convince your private
insurance agency to provide coverage based on the “covered
services” sections of your handbook (e.g., prosthetic devices,
durable medical equipment, speech therapy and supplies).
Schools: Schools are
required by law to provide assistive technology equipment. The
requirement for
AAC
equipment, repair and periodic replacement may be put in an
IEP.
Medicaid: Most states
cover the purchase of
AAC
equipment for individuals up to age 21, and many cover the
purchase of equipment for individuals of all ages. However, each
state’s coverage guidelines vary. An equipment manufacturer
should be familiar with your state’s funding practice. The
manufacturer should help you determine what documentation
requirements are necessary for equipment funding through your
state’s Medicaid.
Division of Vocational
Rehabilitation: Services through
VR
are typically tied directly to a plan of action that has been
developed by an individual with their
VR
counselor for the purpose of seeking employment. If use of
AAC
is required in order to accomplish established objectives,
funding for the recommended equipment will probably need to be
arranged by
VR
in collaboration with the equipment manufacturer.
Funding for Ongoing Clinical SupportPrivate Insurance: Many private insurance
carriers will fund speech therapy. Prior authorization may be a
requirement and/or there may be coverage limitations (cost
allowances, duration, etc.). This depends completely on what
coverage is listed in your policy. You should refer to your
policy handbook prior to contacting your insurance company to
discuss coverage.
Schools: Schools are
required by law to provide assistive-technology services. If the
school does not have qualified providers, a qualified provider
should be identified and appropriate services provided at the
school’s expense. A requirement stating that the serving
SLP
have certain
AAC
experience may be put in an
IEP.
Medicaid: If your
Medicaid covers speech therapy (most do), you can seek
therapeutic support via Medicaid. Inquire with the
SLP
of your choice whether or not they accept Medicaid reimbursement
for their services.
Division of Vocational
Rehabilitation: Services through
VR
are typically tied directly to a plan of action that has been
developed by an individual with their
VR
counselor for the purpose of seeking employment. If use of
AAC
is required in order to accomplish established objectives,
funding for the ongoing services will probably need to be
arranged by
VR
in collaboration with the
SLP.
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