Funding - Medicare Questions
Q: My family member lives in a nursing home setting. Are we able to use their Medicare coverage to receive a device?
A: Nursing home residents are not able to receive Durable Medical Equipment (DME) through Medicare. Medicare Part B only covers the cost if you are living at home or in a group home setting. Certain residents who have been diagnosed with mental retardation and are living in intermediate care facilities are also eligible.
Note: Persons receiving hospice care are not able to use their Medicare benefits to purchase a speech device. This applies to both in home hospice care as well as facility based hospice care.
Q: Can I purchase the device and then be reimbursed by Medicare?
A: Unfortunately, no.
Q: Why can’t Tobii Dynavox just waive the 20% co-payment?
A: While we understand that this co-payment may be difficult to come up with, it is against Medicare policy to waive this cost. Please let your funding coordinator know as soon as possible if you do not have a secondary insurance carrier, as we may be able to recommend an alternate funding source or setup an interest free payment plan.
Q: Can I fax the documentation?
A: Yes, our fax number is 866-336-2737.
Q: How long will it take until I receive my device?
A: There is no prior authorization process with Medicare. When the required documentation has been received by Tobii Dynavox, we can ship your device to you.
Q: Can you ship the device directly to the speech therapist?
A: No. We understand that it often is convenient to have someone else receive the device for programming and training. However, Medicare requires us to furnish proof that the device was delivered to the device user. It is our policy without exception to deliver only to the client’s residence. We apologize for any inconvenience.
Q: I was informed that I need to get a new prescription. I don’t understand why the first prescription was not good enough.
A: Medicare does have strict guidelines for prescriptions. The prescription must specifically list all equipment being ordered. The best way to ensure that this happens is to provide your doctor with a copy of the quotation. Our prescription form may be used to ensure that the guidelines have been met.
Note: If you do not have a quotation, you can call our Customer Sales and Support Department at (800) 344-1778. It is always a good idea to have a quotation on file. It helps to ensure that your order is correct and that all necessary accessories are included.
Q: I had a speech evaluation 2 years ago. Can the speech therapist use the old evaluation?
A: No. The speech evaluation must be no more than 6 months old at the time the device is shipped to you. A new evaluation will be needed.
Q: I have a Medicare replacement policy. What steps do I need to take to obtain a device?
A: Obtaining funding through a Medicare replacement policy is slightly different than traditional Medicare funding. The Medicare guidelines should still be followed. However, a prior authorization review is required in these cases. In other words, the speech therapy report, prescription, and Face to Face should follow Medicare rules, but we will also need to follow the rules of your insurance carrier. Please see the Private Insurance FAQ section for additional details.