Medicare Coverage of Speech Generating Devices (SGD)Medicare will cover the cost of a SGD if you have Medicare Part B services.
1. You must live in your family home or an assisted living facility
2. Medicare will not cover the cost of a SGD if you are in a hospital, skilled nursing facility, or on hospice.
*Medicare will cover 80% of the allowable cost of the device. Secondary insurance should pay the remaining 20% but that is not always the case. If you do not have secondary insurance, you will be responsible for the 20% co-pay. There are funds available from charitable organizations that may help pay for any deductible or co-pay that insurance does not cover.
*Medicare classifies SGD’s as “durable medical equipment” (DME) and will cover the device under this classification.
*An assessment by a speech-language pathologist is required to document that this device is needed to meet your daily functional communication needs. 80% of the cost of the assessment is covered by Medicare. The remaining charge can be billed to secondary insurance (if applicable) or will be billed to the client.
*A doctors prescription is required.
*Once the assessment has been completed, appropriate paperwork will be submitted to the vendor of the device. This process usually takes approximately one to two months.
*If the vendor feels all the paperwork is in order, they will ship the device directly to you.
Training on your device can be provided by:
> Vendor—many vendors offer training sessions at no cost.
> Facility—the facility where you received your device can provide training. The cost of the training session is covered by Medicare.
> Chapter—the ALS Association may have resources available for training.
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