¶ Medical Equipment and Assistive Technology
Assistive technology (AT) and medical equipment can transform disabled people's lives—enabling independence, communication, mobility, and participation. But accessing what you need often requires navigating complex funding systems, fighting denials, and learning to advocate effectively.
This page centers disabled people's expertise on getting, using, and affording assistive technology.
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¶ Understanding AT and Medical Equipment
Medical equipment/durable medical equipment (DME): Equipment primarily used for medical purposes—hospital beds, oxygen equipment, nebulizers, CPAP machines, wheelchairs (when considered medical).
Assistive technology (AT): Broader category including any device or system that helps a disabled person do something they couldn't do otherwise or do it more easily. Includes mobility devices, communication devices, computer access, daily living aids, and more.
The categories overlap significantly, and funding sources may use different definitions.
Mobility:
- Manual wheelchairs
- Power wheelchairs
- Scooters
- Walkers, rollators, canes
- Prosthetics and orthotics
- Adaptive vehicles
Communication:
- Augmentative and alternative communication (AAC) devices
- Speech-generating devices
- Communication boards
- Apps for communication
Vision:
- Screen readers
- Screen magnifiers
- Braille displays and notetakers
- Optical aids
- Electronic magnifiers (CCTVs)
Hearing:
- Hearing aids
- Cochlear implants
- Assistive listening devices
- Captioning services and devices
- Alerting devices (visual/vibrating alarms)
Computer access:
- Alternative keyboards
- Eye-tracking systems
- Voice recognition software
- Switch access
- Adapted mice and trackballs
Daily living:
- Adapted utensils and kitchen tools
- Dressing aids
- Bathing and toileting equipment
- Environmental controls
- Smart home technology
- Medication management systems
Cognitive:
- Reminder systems
- Task prompting apps
- Simplified technology
- Time management tools
- Note-taking and organization software
Getting AT funded in the US often requires combining multiple sources:
Medicare:
- Covers durable medical equipment (DME) under Part B
- Must be medically necessary
- Must be prescribed by a doctor
- Supplier must be Medicare-approved
- 20% copay typically applies
- Limited coverage for maintenance and repairs
Medicaid:
- Coverage varies by state
- Often covers more AT than Medicare
- May have different (sometimes easier) approval processes
- Prior authorization typically required
Private Insurance:
- Coverage varies widely by plan
- Check your policy for DME benefits
- Prior authorization often required
- May have annual limits
State Vocational Rehabilitation (VR):
- Can fund AT related to employment
- Must be working with VR on employment goal
- Significant funding possible
Schools (IDEA):
- Must provide AT necessary for FAPE
- Remains at school (doesn't go home)
- Evaluated through IEP process
State AT Programs:
- Every state has an AT Act program
- May offer loans, reuse programs, demonstrations
- Find yours: ataporg.org
Veterans Affairs:
- VA provides AT to eligible veterans
- Often more comprehensive than other programs
Private Foundations and Charities:
- Many organizations provide specific equipment
- Disease-specific organizations often help
- Local service clubs (Lions, Rotary) may assist
Out of Pocket:
- Sometimes the only option
- Consider used equipment, refurbished, or lower-cost alternatives
Wheelchairs are often complex to get covered:
Medicare criteria distinguish between:
- Scooters (lowest tier, limited coverage criteria)
- Group 1 wheelchairs (basic, limited coverage)
- Group 2 wheelchairs (more features)
- Group 3 wheelchairs (complex rehabilitation technology)
- Power chairs (various groups)
What's required:
- Face-to-face examination with doctor
- Prescription with mobility diagnosis
- Often requires seating evaluation (especially for complex chairs)
- Documentation of medical necessity
- Prior authorization from insurance
Tips:
- Work with a complex rehab technology (CRT) supplier, not just any DME company
- Get evaluated by a seating specialist (PT/OT)
- Document functional limitations thoroughly
- Specify features needed and why
- Appeal denials—many are overturned
Communication devices (speech-generating devices):
- Medicare covers SGDs under speech-language pathology benefit
- Requires evaluation by SLP
- Must demonstrate need and ability to benefit
- Prior authorization required
- Some devices require rental before purchase
Tips:
- Get thorough evaluation documenting communication needs
- Document that other methods aren't sufficient
- Work with SLP experienced in AAC
- Appeal denials with detailed documentation
Hearing aids are often poorly covered:
- Medicare doesn't cover hearing aids (one of the biggest gaps)
- Medicaid coverage varies by state (children often covered; adults vary)
- Private insurance rarely covers fully
- Average cost: $2,000-7,000 per pair
Resources:
- State programs for low-income individuals
- Lions Club hearing aid programs
- Hearing aid manufacturer programs
- Used/refurbished hearing aids
Getting the right AT starts with good assessment:
Who can assess:
- Occupational therapists (often)
- Physical therapists (mobility)
- Speech-language pathologists (communication)
- Assistive technology professionals (ATP certification)
- Rehabilitation engineers
Where to get assessed:
- Hospitals and rehab centers
- State AT programs
- Independent living centers
- University AT clinics
- Private practices
Disability Rights organizations help with AT access issues.
State AT programs (under the AT Act) provide resources and advocacy.
RESNA (Rehabilitation Engineering and Assistive Technology Society of North America) sets standards and certifies practitioners.
National disability organizations often work on AT policy.
AT funding varies significantly by province.
Assistive Devices Program (ADP) (Ontario):
- Covers portion of many devices
- Requires authorized vendor and prescriber
- Waiting lists for some items
Provincial health programs:
- May cover some equipment
- Varies by province and item
Social assistance:
- ODSP, AISH, and equivalent programs may provide AT funding
Workers' Compensation:
- Covers AT related to workplace injuries
Private Insurance:
- Extended health benefits may cover some AT
- Contact your provincial health ministry for programs
- Connect with disability organizations who know local resources
- AT society/program in your province
- Apply to multiple sources for expensive items
- Neil Squire Society: Technology access programs
- March of Dimes Canada: Assistive devices programs in some regions
- Provincial AT organizations
The NHS provides some AT:
- Wheelchairs through NHS wheelchair services
- Communication aids through some Speech and Language Therapy services
- Some daily living equipment through community services
Limitations:
- Basic wheelchairs often provided; specialized chairs harder to get
- Postcode lottery—services vary by area
- Waiting times can be long
- May not cover preferred or optimal equipment
¶ Social Care and Community Equipment
Local authorities provide:
- Daily living equipment following needs assessment
- Some home modifications
- Eligibility and provision vary
If you have social care personal budget:
- May be able to purchase AT
- More control over what you get
- Can top up if needed
For students:
- Can fund AT needed for education
- Includes computers, software, specialized equipment
- Requires needs assessment
Some AT requires private purchase:
- Hearing aids often need private funding
- Advanced technology may exceed NHS provision
- Top-ups possible for some items
NHS wheelchair services campaigns push for better provision.
Communication Matters advocates for AAC access.
Disability charities may provide equipment grants.
The National Disability Insurance Scheme funds AT for participants:
AT categories:
- Assistive technology for daily living
- Mobility equipment
- Communication devices
- Technology for access
How it works:
- AT must be in your NDIS plan
- May be self-managed, plan-managed, or agency-managed
- Complex AT requires assessment and justification
- Some AT is "stated supports" (easy to request); complex AT requires more documentation
Getting AT funded:
- Have AT goal in your plan
- Get assessment/recommendation from therapist
- Request quote from supplier
- Get approval (depending on management type and amount)
- Purchase
Some AT is still state-funded:
- Medical equipment through health departments
- Vision aids through Vision Australia
- Hearing services through Hearing Australia
¶ Aids and Equipment Programs
States have programs for people not on NDIS:
- Often for people over 65
- Limited funding and waiting lists
AT Australia provides information and advocacy.
Independent Living Centres offer AT information and assessment.
NDIS Appeals Support helps with funding disputes.
AT access ranges from comprehensive government provision to virtually no support:
- Nordic countries: Generally strong AT provision
- Many European countries: Mix of health and social systems
- Global South: Often limited formal provision; community solutions important
- Contact national disability organizations in your country
- Research government programs for medical equipment
- Look into international NGOs providing AT (in Global South)
- Connect with rehabilitation professionals
- Explore peer networks for informal solutions
- WHO Priority Assistive Products List: Framework for essential AT
- ATscale Global Partnership: Works to increase AT access globally
- CBM: Provides AT in many countries
Good AT starts with good assessment:
- Don't just buy something—get evaluated
- Consider your specific needs and goals
- Trial equipment before committing
- Consider your environment (home, work, community)
- Think about maintenance and training needs
- Occupational therapists: Daily living, computer access, general AT
- Physical therapists: Mobility equipment
- Speech-language pathologists: Communication devices
- Audiologists: Hearing aids and assistive listening
- Low vision specialists: Vision AT
- Certified ATP/SMS: Complex rehabilitation technology
Whenever possible:
- Borrow equipment to try
- State AT programs have loan programs
- Vendors may offer trials
- Ask about return policies
Getting AT is just the start—you need to learn to use it:
- Insist on training as part of the process
- Get follow-up support
- Connect with peer users
- Online resources and communities can help
¶ Maintenance and Repair
AT requires maintenance:
- Wheelchairs need regular maintenance
- Software needs updates
- Batteries wear out
- Things break
- Medicare: Limited coverage for repairs
- Medicaid: Varies by state
- Private insurance: Check your policy
- Warranty: Know your warranty terms
- Out of pocket: May be necessary
- Learn basic maintenance yourself
- Keep equipment clean and stored properly
- Address problems early before they become big repairs
- Know your rights to timely repairs
Get a comprehensive seating evaluation from a CRT supplier (not just any DME company). Have your doctor document in detail why you need power mobility. Appeal denials—provide extensive documentation of your functional limitations and failed attempts with other mobility options.
Look into state programs for low-income individuals. Contact Lions Club International. Check if your insurance has any coverage. Explore costco or online hearing aids (for mild-moderate loss). Some audiologists offer payment plans.
Request reassessment. Document what's not working. Ask about upgrades or different models. If your needs have changed, request new evaluation. Know that you're entitled to equipment that actually meets your needs.
Request a speech-language pathology evaluation specifically for AAC. Your school (if applicable), state AT program, or hospital can connect you with SLPs who specialize in AAC. Trial different systems before deciding.
¶ "My equipment broke and I can't get it fixed"
Know your rights to timely repairs. Document the breakdown and requests for repair. Contact your funding source about repair coverage. If stuck, contact disability rights organizations or state AT programs.
RESNA works on AT standards and access.
State AT programs advocate for AT access in their states.
ASHA (American Speech-Language-Hearing Association) advocates for communication access.
Disability Rights organizations fight for AT coverage.
Equipment-specific organizations (AAC users, wheelchair users, etc.) advocate for access to their technologies.
- WHO Priority Assistive Products List: who.int/publications/i/item/978924001808
- ATscale Global Partnership: atscalepartnership.org
- Neil Squire Society: neilsquire.ca
- Provincial assistive devices programs
Have you navigated AT funding? Found good assessors? Have tips for getting equipment covered?
Share your knowledge: Contribution Form
We especially welcome:
- Funding strategies that worked
- Equipment recommendations
- Country-specific information
- Tips for specific types of AT
This page centers disabled people's expertise. Disabled people are the experts on what technology works for them and how to navigate broken funding systems.
Last updated: November 2025