• Disability Studies
• Community Training
  & Service
• Research/Evaluation
• Assistive Technology
• Information Services

Assistive Technology in Healthcare

Page 1

Private and public (Medicaid, Medicare, Children's Health Insurance Program) health insurance and managed care plans vary widely in paying for assistive technology devices, such as durable medical equipment, and services, such as therapies. Coverage depends on benefits packages, including dollar caps on specific benefits, and "medically necessity" in individual cases. Assistive technology often can be medically necessary to prevent, diagnose, alleviate, correct, eliminate, or cure the effects of a condition, illness, injury or disability; prevent worsening or secondary conditions; and assist individuals to achieve, maintain or improve their individual functional capacity in performing daily activities. Available patient rights and protections when a plan denies a benefit also affect coverage. The ultimate challenge for people with disabilities may be the most basic: obtaining health care coverage.

Best practice and advocacy resources:

• Medicare Rights Center.
  (http://www.medicarerights.org/Index.html)
  Information about Medicare, including information on access to durable medical equipment.
• STARLink.
  (http://www.txheart.org/starlink.html).
  STARLink advocates provide support and information to persons enrolled in or eligible for Medicaid managed care in Texas.
• Consumers Union.
  (www.consumersunion.org/health/openenrosw1098.htm).
  Texans have New Tools When Choosing Health Care Plans.
• AARP.
  (www.aarp.org/hcchoices).
  Educated Health Care Choices: Making the System Work for You.
• Research and Training Center on Managed Health Care and Disability .
  (www.bcm.tmc.edu/ilru/mgdcare/mclinks.html#dictionaries).
  List of web resources.
• Institute for Child Health Policy.
  (www.ichp.edu/managed/materials/purchaser).
  Evaluating Managed Care Plans for Children with Special Health Care Needs: A Purchaser's Tool.
• American Academy of Pediatrics.
  (www.aap.org/family/mancarbr.htm).
  How to Use Your Managed Care Plan Effectively: Questions and Answers for Families With Children
• CPT Codes and Assistive Technology.
  (www.resna.org/taproject/policy/health/CPTcodes.htm).
  How services related to assistive technology are coded for reimbursement in public and private insurance.
• Rehabilitation Engineering Research Center on Communication Enhancement.
  (www.aac-rerc.com/index.asp).
  Medicare funding for Augmentative and Alternative Communication (AAC) Technology.
• RESNA Technical Assistance Project.
  (www.resna.org/taproject/policy/initiatives/mednec.html).
  What should be in a letter of medical necessity for assistive technology.
• Neighborhood Legal Services.
  (www.resna.org/taproject/policy/initiatives/pipa.htm).
  Private insurance contracts and assistive technology: Part I.
• Neighborhood Legal Services
  (www.resna.org/taproject/policy/initiatives/pipb.htm).
  Private insurance contracts and assistive technology: Part II
• National Health Law Program.
  (http://www.healthlaw.org).
  National advocacy organization for improved health care for low-income persons.
• Families, USA.
  (www.familiesusa.org).
  National advocacy organization for health care reform.