Join CafeMom Today! Autism Spectrum Disorder: Treatments: Medicare covers $8k Dynavox, not $300 iPhone

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Monday, November 16, 2009

Medicare covers $8k Dynavox, not $300 iPhone

OK, let's see. Medicare will cover an $8,000 talking device, but not a $300, because you might play games on it. It sure seems like someone might be missing the point.
For voiceless, gadgets speak but insurers balk


THE NEW YORK TIMES

SAN FRANCISCO — Kara Lynn has amyotrophic lateral sclerosis, which
has attacked the muscles around her mouth and throat, removing her
ability to speak. A couple of years ago, she spent more than $8,000 to
buy a computer, approved by Medicare, that turns typed words into
speech that her family, friends and doctors can hear.

Under government insurance requirements, the maker of the PC,
which ran Microsoft Windows software, had to block any nonspeech
functions, such as sending e-mail or browsing the Web.

Dismayed by the PC's limitations and clunky design, Lynn turned to
a $300 iPhone 3G from Apple running $150 text-to-speech software. Lynn,
who is 48 and lives in Poughkeepsie, N.Y., said it worked better and
let her "wear her voice" around her neck while snuggling with her
5-year-old son, Aiden, who has Down syndrome.

Medicare and private health insurers decline to cover devices such
as iPhones and netbook PCs that can help people with speech
impairments, despite their usefulness and lower cost. Instead, public
and private insurers say that if Lynn and others like her want
insurance to pay, they must spend 10 to 20 times as much for dedicated,
proprietary devices that can do far less.

The logic: Insurance is supposed to cover medical devices, and
smartphones and PCs can be used for nonmedical purposes, such as
playing video games or browsing the Web.

"We would not cover the iPhones and netbooks with
speech-generating software capabilities because they are useful in the
absence of an illness or injury," said Peter Ashkenaz, a spokesman for
the U.S. Centers for Medicare and Medicaid Services. Private insurers
tend to follow the government's lead.

Two years ago, iPhones and netbooks barely existed, so it may not
be surprising that the industry has yet to consider their role as
medical devices.

[MORE]

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