Assistive Technology Corner...
Ideas for Funding the Assistive Technology Your Child Needs
By Randi Sargent
A new study published in the American Journal of Occupational Therapy found that assistive technology (AT), when employed by a team of therapists and educators, has significant impact on helping children with disabilities achieve their educational goals*. Assistive technology is a broad term that includes a wide range of devices that make it easier for individuals with disabilities to perform certain tasks. Examples include wheelchairs, orthotics, communication devices, computers, software, adapted utensils, dressing aides, large print materials, and even Velcro. In general, AT that is medically necessary is called Durable Medical Equipment (DME). Some AT is very expensive and many families will require financial assistance to purchase it. Here are eight ideas for funding the AT your child needs to succeed in school, community, and family life.
- Some private health insurance plans have a DME benefit. If you have private health insurance, read your service benefit plan or call your insurance company and ask about DME coverage. Every plan is different, so this benefit will vary by company and type of policy. Be sure to ask about the types of DME they cover, any maximum amount the insurer will pay, the co-payment you must pay, if you need a physician’s prescription and prior authorization, and if they have preferred suppliers or vendors from whom you must get the item. The physician will also have to document the medical necessity of the item.
- Most of the MassHealth (Massachusetts Medicaid) programs include payment for DME. If your child qualifies for one of the MassHealth programs, and you also have private health insurance, MassHealth will help pay the difference between what your private plan covers, and your share of the cost. If MassHealth is your child’s only insurance, DME is covered if the item is deemed to be medically necessary. Again, you need a physician’s prescription, prior authorization, documentation for the medical necessity of the item, and will have to purchase the item from a MassHealth vendor. [Editor’s Note: if you need information about MassHealth, the Massachusetts Family-to-Family Health Information Center at the Federation can help you understand the different pathways to coverage, your child’s eligibility and the application process. Call 1-800-331-0688, ext. 210.]
- Your school system - If your child requires AT to access the curriculum and meet his or her academic goals, then your school district is required to provide it. Be sure this need is documented on the child’s IEP. The equipment is the property of the school, not yours, so certain restrictions about when and where it is used may apply.
- Grants from civic organizations or disability specific organizations - Civic organizations, such as the Knights of Columbus, provide grants to children with cognitive and physical disabilities who are younger than 20 years old. Contact your local Knights of Columbus at www.massachusettsstatekofc.org, or other organizations in your town, for information about making a Charity Fund request. Some disability specific organizations, such as the Muscular Dystrophy Association (www.mda.org), also fund DME. [Editor’s Note: Family TIES of Massachusetts has information about many disability-specific organizations and can help you find local contacts. Call Family TIES at 1-800-905-TIES or visit the Family TIES Resource Directory at www.massfamilyties.org.]
- Low interest loans - Easter Seals manages the Massachusetts AT Loan Program and the Mini-Loan Program to help fund large and small AT. Easter Seals also has AT Regional Centers in Boston and Pittsfield where you can see demonstrations and borrow trial equipment prior to purchasing. Learn more about the Easter Seals AT loan programs at www.eastersealsma.com.
- If your home requires modifications for accessibility or safety, the Massachusetts Rehabilitation Commission offers the Home Modification Loan Program, which provides no and low interest loans. Learn more at www.mass.gov/mrc/hmlp.
- Catastrophic Illness in Children Relief Fund (CICRF) - CICRF is a reimbursement program that offers financial assistance to families that have spent more than 10% of their annual income, for family income less than $100,000/year, on expenses related to their child’s diagnosis, but for which there is no other payer. If family income is more than $100,000/year, your unpaid expenses must include an additional 15% of the amount over $100,000. Download the application and read the list of eligible expenses at www.mass.gov/cicrf.
- Some children’s hospitals have special funds to help families meet needs that insurance does not cover. Ask the nurse practitioner or social worker in your clinic for information.
MassMATCH, the Massachusetts’s Initiative to Maximize Assistive Technology in Consumer’s Hands (www.massmatch.org) provides technical assistance about AT, loan and swap programs, and more. They can also provide demos of products so your child can try it before you buy it. Whatever you purchase to help your child, save your receipts! Many assistive technology items, therapeutic activities, and the health insurance premiums, as medical expenses, may be tax-deductible!
*Effect of Assistive Technology in a Public School Setting, Anne H. Watson, PhD, OT/L, Max Ito, OTR/L, Roger O. Smith, PhD, OT, FAOTA, Lori T. Anderson, EdD, OTR/L, FAOTA, American Journal of Occupational Therapy, January/ February 2010.
Randi is the parent of a child with cerebral palsy who relies on assistive technology for mobility, communication and daily living. Randi is also a member of the MassMATCH AT Advisory Committee and the Federation Board of Directors.