Human ingenuity and modern technology have combined to produce some wonderful advances in the field of assistive technology for the disabled. Unfortunately these advances come with some very large price tags. President Clinton this week announced that he is including $100 million in his budget for disability and technology research.

He has also directed the Secretary of Health and Human Services to convene an interagency Task force on Health care coverage of Assistive Technologies. Included would be the DHHS, Justice Education, Labor, Veterans Affairs. His plan is for the task force to study the role that Medicare and Medicaid does and should play in the coverage of assistive technology devices. It will look at the role of Medicare and Medicaid in covering assistive technologies that encourage and support employment of the disabled.

With President Clinton's announcement there is hope for the future, hope that assistive technology will continue to improve lives, and be accessible for all disabled. But for today, who and how assistive technologies are paid for is the problem. Let's look at what Medicare, Medicaid and private insurance pays for and what they don't pay for, today.

Medicare
Medicare benefits have been expanded over the years to include some preventive services, but continue to cover mainly acute care services. Assistive devices such as wheelchairs and scooters are covered when the person meets medical criteria. Other assistive devices such as white canes are not covered.

Medicaid
Medicaid is a federal program that provides health coverage for lower income and disabled people. These plans are administered by the states and the benefits will vary. It does cover nursing home care and personal care in the home in some instances.

Private Insurance
Most private insurance carriers base their coverage on HCFA (Health Care Financing Administration) guidelines. If Medicare adds coverage for devices or procedures the private insurers generally will follow suit.

• Wheelchairs

These are generally covered if the insured meets coverage guidelines, such as being unable to walk more than short distances (less than 50 feet). Motorized wheelchairs would only be covered if there is diminished upper body strength such as with arthritis or ALS (Lou Gherigs.
• Reachers, large gripped eating utensils, etc.

Those nifty little devices that help people with arthritis pick up items, help them button their clothing or eat a meal independently are generally not covered under Medicare or insurance. They can be costly, a simple spoon with a large grip can be $5.00. Some private foundations such as the Lighthouse for the Blind and the Arthritis Foundation can help with the cost of these assistive devices.
• Home Modifications

Wheelchair ramps, widening doorways and lowering counter height can mean the difference between dependence and independence for some. Medicare does not cover these modifications, nor do most private insurance. If the disability is service related the Veterans Administration does cover some of these modifications. For others Medicaid or charitable foundations may be the place to go for assistance.

Previous Articles

If you have any questions or comments on senior health, nutrition, fitness, etc., go to the Senior Health Forum where we are talking about the following: