How To Control Costs of Assistive Devices

From wheelchairs to speech recognition software, assistive technology and devices support people with disabilities in the community, at school and in the workplace. More than 2.5 million people worldwide use these tools, and this number will likely increase to 3.5 million by 2050, according to the World Health Organization.

A single device could cost $20,000 or more. For example, a car can be purchased with accessibility features or modified with ramps, chair lifts and hand controls. According to the National Highway Safety Transportation Board, a new car with adaptive equipment could cost up to $80,000. 

Paying for assistive technology and devices may require a patchwork of insurance, out-of-pocket costs and loans. Another option may include borrowing equipment.

We spoke with BECU employees and researched several ways to fund assistive technology.

Assistive Technology and Devices: Options and Opportunities

1. Determine Which Assistive Technology and Devices You Need

You may already know which technology or devices you need; if not, ask your medical provider for a referral for an evaluation. Your medical provider will likely need to provide a letter of medical necessity or prescription. Discuss with your medical provider if your needs are temporary or permanent.

Here are some examples of assistive tools for different purposes:

• Mobility aids: Manual and power wheelchairs, stair lifts, walkers, canes, crutches, scooters, prosthetic devices, orthotic devices.
• Hearing adaptive devices: Hearing aids, cochlear implants, bone conducting headphones.
• Assistive technologies: Headphones, voice recognition programs, screen readers, screen enlargement applications, braille electronic notetakers, software, apps.
• Physical modifications to homes and vehicles: Ramps, handles, grab bars, lifts, wider doorways.
• Daily living aids: Medication dispensers, reachers, extended grabbers, adaptive eating utensils, clothing identifiers.

To try before you buy, check out the Washington Assistive Technology Act Program. WATAP's device lending library ships more than 500 items for 21 days of use, for a small fee. The Lending Program allows you to borrow an assistive technology device, which can be shipped anywhere in Washington state for 21 days.

WATAP's lending library offers devices that assist mobility, hearing, vision, speech communication and daily living. The library's database has devices ranging from a digital artificial larynx for communication to a self-stabilizing eating utensil that reduces shaking.

2. Research Costs of Assistive Technology and Devices

Compare estimated costs of assistive technology and devices. National advocacy organizations can offer tips on where to find devices for less, or you can search sites like Reddit for crowdsourced recommendations.

If you have health insurance coverage, your insurer is the first place to seek help with assistive device costs. You'll likely need prior authorization and proof of medical necessity. The types of insurance that may help cover devices include:

• Employer-provided health care (group plan)
• Affordable Care Act Marketplace plan
• Medicare
• Medicaid
• Veterans Affairs or Tricare (for active and retired military service members)
• Disability insurance

One BECU employee used employer-based health insurance coverage to pay for Signia hearing aids.

"I was really lucky Premera started covering hearing aids," the employee said. "The last pair cost about $3,000 out of pocket."

Because insurance covered the total cost of hearing aids, the employee had enough money to pay out of pocket for a StreamLine Mic, which can be used to make cell phone calls or with a work laptop to make calls and join meetings.

Medicare helped another BECU employee pay for her mother's electronic pill dispenser, which can be programmed to drop up to 10 pills throughout the day. Her mother has multiple sclerosis, a chronic neurological condition.

The BECU employee uses a phone app to program and do one-time drops. The app sends an alert if the employee's mother didn't take the pills.

"This saved my mom thousands of dollars per month as she was taking pills three times daily and wouldn't be able to remember to take them all on her own," the employee said.

The employee also paid out of pocket for a $250 sliding shower chair and transfer bench. However, this expense was lower than paying for human assistance for entering and exiting the shower, which added up to $1,000 monthly.

3. Research Funding Options

If insurance doesn't cover the bill for the needed technology or devices, research other ways to pay or acquire the tools you need. Options may include borrowing an assistive device, getting a low-interest loan, using funds set aside in an ABLE plan (described below) or another approach.

Ways to Pay for Assistive Devices

Beyond insurance coverage, you may have access to some innovative approaches for covering assistive devices.

Loans for Access

Northwest Access Fund offers assistive technology loans to Washington, Oregon and Idaho residents with disabilities. The loans can be used for assistive technology tools, adaptations for homes and vehicles, hearing aids and dentures. The loans can even cover services related to assistive technology, such as evaluations and training, maintenance and repair, device insurance and extended warranties. 

As of the time of this writing, qualified applicants could borrow up to $25,000 for most assistive technology and $60,000 for home modifications. Loan terms ranged from five to 10 years. The interest rate for assistive technology and home modification was 5%, while a variable rate was set for adapted vehicle loans. Check current rates and terms if you're thinking about borrowing.

Applicant credit is checked, although less-than-optimal credit doesn't necessarily disqualify someone. Instead, NAF reviews applicants' credit based on multiple factors, including income, expenses, debts and resources.

Family members, employers and other representatives can also apply for a loan if they are purchasing an item for someone with a disability.

ABLE Plans

ABLE accounts, named for the Stephen Beck, Jr., Achieving a Better Life Experience Act of 2014, are set up by or for people with disabilities, and individual states establish and maintain ABLE Account programs.

Washington residents with a qualifying disability before age 26 can open a Washington State ABLE Savings Plan account. Up to $18,000 a year can be saved and invested in the account without affecting other benefits (as long as the account balance remains below $100,000). Employed account holders can contribute even more.

ABLE account investments include (PDF) cash-only and three mutual fund options: Conservative, moderate or aggressive, depending on the investment period. Speak with a financial professional to determine the right course of action.

If a young person cannot open the account, a parent or authorized legal representative can open it for them. A prepaid Visa card can be loaded with up to $20,000 of account funds to be spent by the beneficiary or the authorized legal representative.

Account funds can be used for various health, quality of life and independent living expenses, including housing, education, transportation, assistive technology and even legal fees.

Reuse and Recycle Assistive Devices

WATAP oversees the Evergreen Reuse Coalition, which connects donated assistive devices with users, often at a physical location. For example, qualifying individuals can visit the Medical Equipment Bank in Lacey, Washington, to borrow wheelchairs, shower benches and canes.

WATAP also offers a classified listing service for buying, gifting and selling assistive equipment.

Another potential option is Emma's Exceptional Equipment Exchange, a non-profit that bridges the gap between what insurance covers and what people with disabilities need to comfortably and safely enjoy basic daily living.

Other Options

Depending on your situation, you may be able to access:

• Employer coverage for workplace accommodation tools so you can perform your job, according to the Americans with Disabilities Act.
• Evaluation and assistance for accessing assistive technology services from the Washington State Division of Vocational Rehabilitation, including hearing and vision aids and computer devices.
• Home Improvements and Structural Alterations (HISA) program benefits for veterans with disabilities.
• Free equipment and training from iCanConnect for people meeting federal disability and income guidelines, including braille devices, computers and phones.
• Programs to help you pay for (partially or in whole) equipment or connect you with other ways to fund equipment from organizations such as the Multiple Sclerosis Foundation.

Sometimes, out-of-pocket costs are unavoidable. But with careful selection of assistive technology and devices, the savings could be considerable. Paying for devices can save money in the long run while promoting independence.

"I would just recommend asking others and researching device options," said one BECU employee. "I had no idea that the transfer bench and pill dispenser I provided for my mom existed, and the money we spent for three years amounted to at least $50,000."

Related Content