Step 6: Identify possible funding sources
The way you plan to use assistive technology will help you determine potential funding sources to contact. First, identify the main purpose of the device—is it a medical necessity, a tool for education or a work accommodation – then select sources that are most likely to provide funding assistance.
Your chances of success in obtaining funding will be greater if you ask:
- A public school to pay for a device or service that is needed to read textbooks, solve math problems, and complete writing assignments.
- Vocational Rehabilitation Services to pay for a device to obtain or keep a job.
- An insurance company, Medicare or Medical Assistance to pay for a device or service that is necessary for good health and well-being, such as a speech generating device for communicating health needs.
Medicare is a healthcare program available to people over age 65 and some people with disabilities under age 65.
Medical Assistance is a joint federal and state program that provides medical and healthcare services to people with low incomes.
Both Medicare and Medical Assistance can pay for certain types of assistive technology that are “medically necessary.”
The definition of “medically necessary” varies depending on the health insurance program. Generally, though, it is defined as, “health care services or supplies needed to diagnose or treat an illness, injury, condition, disease or its symptoms and that meet accepted standards of medicine.” Determination is made on an individual basis and must have a reasonable chance for a substantial benefit by preventing regression or by maintaining or improving functioning.
Make a List
Once you have determined what you need (Step 2) and have a general idea of the costs (Step 4), you can begin to look for help in paying for the assistive technology devices and services you need. Make a list of possible funding sources, then prioritize them. This will give you options should you have difficulty with your primary choice. You may also find two different funding sources that will equal or approach the total cost of your needs.
Key questions to ask when making your list are:
- Have you dealt with this source before?
- Were you successful?
- What problems did you encounter?
- Who was the contact person?
Additional funding sources include private insurance, Rehabilitation Services, Medicaid, Department of Veteran Affairs, local service clubs, nonprofit and advocacy organizations, device manufacturers, school districts, foundations, crowd-funding websites, personal loan and private sources, and many more.
Tips for Approaching Funding Resources
When approaching funding sources, it is important to note that there is no one specific method to assure funding. Traditional sources that have provided funding for assistive technology in the past might be currently undergoing a period of adjustment. If the assistive technology is new to the marketplace, the funding source may take a “hands-off” attitude. Knowing these things will be important to help you plan your strategy and show patience and respect when dealing with prospective funding sources.
Some helpful hints are:
- Be polite and pleasant, but always be businesslike.
- Communicate in writing whenever possible and keep a copy for yourself.
- Maintain a routine connection with the funding source and do not permit time gaps of three or more months between communications.
- Encourage a positive working relationship by directing letters or calls to the same person each time.
- Offer your cooperation and willingness to provide proof of medical necessity and to show how the technology will benefit the consumer and the funding source.
- When questioned, try to educate and inform in an assertive fashion, emphasizing long-term monetary benefits to the funding source.
- Never threaten with legal action, unless you know that you are being discriminated against. This is an often-heard threat and will not intimidate any agency or insurance company.
- Express your sincere thanks and appreciation when someone (a case manager, therapist, AT specialist, durable medical equipment (DME) deal, etc.) goes out of her or his way to help.
- Document all written and verbal communication in details.
- Remain patient and diplomatic while being persistent.
- Keep records of names of people to whom you spoke, what was said, and to whom you were referred next. Keep copies of everything you send in.
- Document, document, and document.
A short explanation of Medicare coverage
Medicare is the federal health insurance program for people who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease. The different parts of Medicare help cover specific services. Medicare Part B covers medically necessary durable medical equipment (DME) that your doctor prescribes for use in your homes, such as wheelchairs, walkers, hospital beds, and blood sugar monitors. Medicare does not pay the full cost of the equipment. If you do not have other insurance, like Medical Assistance, you may be responsible to pay part of the cost of the equipment. For more information on Medicare coverage of equipment and supplies go to: https://www.medicare.gov/what-medicare-covers/part-b/durable-medical-equipment.html.
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