What are communication supports?
Communication supports are ways for people who cannot access verbal or audio information to receive it visually or ways for people who are non-verbal to communicate with people who speak. Communication supports are sometimes called Augmentative Communication Devices (ACD), Augmentative and Alternative Communication (AAC), Assistive Technology (AT), or Durable Medical Equipment (DME).
What is Augmentative Communication Device (ACD)?
An Augmentative Communication Device is Computer and non-computer based electronic devices that provide individuals whose natural speech is not functional with a means of communication. Such technology is evaluated and recommended based on the software, hardware and peripheral features that are matched to an individual’s abilities and daily needs. Communication supports are sometimes called Augmentative and Alternative Communication (AAC), Assistive Technology (AT), or Durable Medical Equipment (DME).
What is Augmentative and Alternative Communication (AAC)?
Augmentative and alternative communication (AAC) is a solution to addressing the communication and other related needs of individuals who experience significant and complex communication disorders. The goal of AAC is to achieve the most effective communication possible for the individual in order to maximize their potential and lead the highest quality of life possible. Communication supports are sometimes called Augmentative Communication Devices (ACD), Assistive Technology (AT), or Durable Medical Equipment (DME).
What is Assistive Technology (AT)?
Assistive technology (AT) is any item, piece of equipment, software program, or product system or services that are used to increase, maintain, or improve the functional capabilities of people with disabilities. Communication supports are sometimes called Augmentative Communication Devices (ACD), Augmentative and Alternative Communication (AAC), or Durable Medical Equipment (DME).
What is a Durable Medical Equipment (DME)?
A Durable Medical Equipment (DME) is equipment that aims to medically help with functional living. All DMEs must meet these criteria in order to be prescribed by a doctor.
DME meets these criteria:
- Durable (can withstand repeated use)
- Used for a medical reason
- Not usually useful to someone who isn't sick or injured
- Used in your home
- Generally has an expected lifetime of at least 3 years
Who pays for communication devices such as ACD, AAC, DME, AT?
In this situation, many factors can contribute to the answer, including technology, the user, and the purpose. Certain expensive and inexpensive communication devices may cost little or nothing. Here are a few examples
- Government programs (Medical, Social Security etc.) pay for some assistive technology if a doctor prescribes it as a necessary medical device such as a Durable Medical Device or DME
- Health Insurance pays for some assistive technology if a doctor prescribes it as medically necessary - School districts pay for materials, services and technology that are required for a student to access
“Free Appropriate Public Education” (FAPE) - Rehabilitation and job training programs funded by the government or private agencies sometimes pay for assistive technology communication devices and training to help people get jobs.
How to get communication support from Insurance?
To get communication support such as a communication device funded through a school district or insurance company, a person will need to prove that it is necessary. However, the term necessary is relative, the meaning of which depends on who you’re talking to. Speak with your doctor, occupational therapist or other health care provider about your needs and ask them to submit an authorization request to your insurance for you. Your insurance company will be looking for medical necessity and your school district will be looking for educational necessity.
What is Medi-Cal?
Medi-Cal is California's Medicaid health care program. This program pays for a variety of medical services for children and adults with limited income and resources. Medi-Cal is supported by federal and state taxes. Medi-Cal coverage includes going to doctors, getting medicine, and funding services and devices needed for communication.
How do I get communication support if my student attends school?
If your student attends school, in writing, ask for an Assistive Technology/Augmentative and alternative communication (AAC) evaluation from the school. Specify that the evaluator should be experienced in AAC, with the use of devices as an AAC modality. Many will evaluate a low tech, a medium tech, and a high tech, and report how your child does with each.When the evaluation comes back that your child qualifies for communication support or devices as an AAC modality, then add it in the Individualized Education Program (IEP) with training.
Medical Necessity vs. Educational Necessity
An insurance company would deem communication support necessary if your child’s verbal speech is limited due to a medical condition such as apraxia. Generally, services, supplies and devices are considered “medically necessary” when they are “reasonable and necessary to protect life, to prevent significant illness or significant disability, or to alleviate severe pain.” For children under age 21, “medically necessary” means “necessary to correct or ameliorate defects and physical and mental illnesses and conditions.”
Your school district would deem communication support necessary when it allows your child to participate in a Free and Public Education (FAPE).
What can I do if my insurance decides not to fund the communication supports that I need?
You can appeal. If you are not happy with your insurance’s decision, you can ask for a fair hearing or resubmit the request with the necessary documentation. If you are in an insurance managed care plan, you can file a grievance with the plan and ask for a fair hearing if you are not happy with the plan’s decision. If you are in a managed care plan, you may be able to also request an independent medical review (IMR) with the California Department of Managed Health Care. Additional information is provided in the link below (DMHC).
What are the benefits of AAC, DME, AT, ACD?
The augmentative and alternative communication device (AAC) support and enhance speech when a person has challenges.
People who use AAC describe benefits of using communication to support:
- improved physical and mental health
- improved personal safety in a variety of care settings, such as hospitals or long-term facilities
- meaningful relationships and stronger friendships
- more robust and more frequent social interactions
- meaningful social roles: family member, friend, professional, student
- increased independence and autonomy and decision-making power over their own life
- enhanced participation in their family lives and communities
- improved information sharing with physicians
- increased employment and volunteer opportunities