Are AAC devices covered by insurance?

What Are AAC Devices and Why Are They Crucial?

Augmentative and alternative communication (AAC) devices give children with speech challenges, including those with autism, apraxia, cerebral palsy, or syndromes, a voice to participate at home, school, and in their community. AAC ranges from low-tech (communication boards, PECs books) to high-tech (speech-generating tablets, apps with dynamic displays).

For many children, AAC goes far beyond basic wants and needs it’s a vital tool for literacy, play, social participation, and self-advocacy across a lifetime. But these devices can cost thousands of dollars, making insurance coverage a key concern for families and care teams.

Will Insurance Pay for My Child’s AAC Device?

Most insurance plans in the United States can cover AAC devices, especially durable, speech-generating devices, if you follow the correct process and show it meets a “medical necessity.” The main types of insurance with potential coverage are:

• Medicaid (state health insurance for children and low-income families)
• Medicare (for children on disability or adults after age 65)
• Private health insurance (through employers, the ACA exchange, or individual plans)

Some states also have supplemental programs, and school districts may provide AAC tools for educational needs. But medical insurance is the only one likely to cover personal, portable, speech-generating devices that go everywhere with the child.

Additionally, insurance will typically only cover a dedicated device.  This means that the device software/apps may be limited to only those that are necessary for AAC and the functioning of the device itself (i.e. settings).  Many of the software/apps that are standard features on most tablets (internet browser, games, wallet, news, etc.) will not be available on a dedicated speech generating device.

*Note:  Insurance will typically cover a new speech generating device EVERY FIVE YEARS, given that all necessary criteria are still met.

What Determines If Insurance Will Approve AAC?

Approval depends on three core criteria:

1. The child must have a significant communication impairment (not able to communicate functionally with speech alone).
2. The AAC device is medically necessary for the child’s health, safety, and participation, as certified by a licensed SLP and physician.
3. Other, less expensive solutions have been considered and found inadequate (demonstrating that picture boards or low-tech aids do not meet all the child’s needs).

Step-by-Step: How to Get an AAC Device Covered by Insurance

1. Assessment: The majority of SLPs prefer to complete a comprehensive speech/language evaluation prior to considering AAC.  This will help the clinician to determine what communication area(s) an individual is having difficulty with.  From this point, the SLP may suggest beginning traditional speech therapy initially before considering AAC options.  Once the SLP and parents have collaboratively determined to proceed with an AAC evaluation, a script from the child’s pediatrician or neurologist will be needed,  Once this is received, the SLP conducts a thorough AAC evaluation, often over a course of several therapy sessions. This should include trials with a variety of devices during a number of different activities.  Recommendations will ultimately be based on motor, cognitive, and communication needs.
2. Documentation: The SLP creates a detailed assessment report. Documentation must show:
   • The nature and severity of the communication disorder
   • Evidence that the device is medically necessary (not just educationally helpful)
   • Comparisons with other communication options (why low-tech alone will not suffice)
   • The child’s ability/willingness to use the recommended AAC device (with data from device trials)
3. Physician’s Prescription: A doctor (often a pediatrician or neurologist) reviews the SLP’s report and writes a prescription for the recommended device. Insurance may also request a “letter of medical necessity” and documentation that the physician has had recent face-to-face interaction with the individual.
4. Submission: The device vendor or SLP team submits a funding request to the insurance company, including all reports, the Rx, and a quote for the device.
5. Insurance Review: The claim is sent to the insurance company to request a “prior authorization.” The claim is processed by the insurance company’s medical review team, who approve, deny, or ask for more information (additional documentation request or ADR).
6. Appeal (if needed): If denied, families and SLPs can appeal with additional evidence or clarifications addressing the insurer’s objections.
7. Device Delivery: Once approved, the device is ordered, programmed, and delivered with training for the user and team.

Summary Table: Steps for Insurance Coverage

Differences Between Medicaid, Medicare, and Private Insurance

• Medicaid: Medicaid is overseen at the state level, so rules and device lists can vary, but most states consider AAC devices to be “durable medical equipment” (DME) and provide strong support. Medicaid often has detailed forms, specific device codes, and may only cover certain brands. Medicaid can cover children, teens, and adults if they meet eligibility and eligibility for DME.
• Medicare: Medicare also recognizes speech-generating devices as DME. Medicare typically covers devices that generate audible output (SGDs), but may set restrictions on the settings where the individual resides.  For instance, Medicare generally won’t pay for AAC devices in Skilled Nursing Facilities (SNFs) because it considers facilities not a “patient’s true home,” classifying AAC devices as “convenience items” rather than essential Durable Medical Equipment (DME) for home use.
• Private Insurance: Private plans vary widely. Some follow Medicaid/Medicare’s criteria, while others have their own formularies, device price caps, or policies. Employer-based and ACA plans may cover more options, but also may require higher co-pays, deductibles, or “prior authorization.” Many require the SLP to be “in-network.”

What Documentation Is Required for Insurance to Cover AAC?

1. SLP’s Evaluation Report describing the child, their communication challenges, all devices/strategies tried, and real communication goals met by AAC
2. Data from AAC trials showing that the child can and will use a device effectively (include photos/logs, if possible and in line with privacy/consent laws)
3. Medical diagnosis (from physician, e.g., autism, cerebral palsy, apraxia)
4. Letter of Medical Necessity (may be co-signed by SLP and physician)
5. Device quote (from manufacturer/supplier)

Insurance reviewers want to see real-world evidence and data, not just general statements about “speech delay.” The report should spell out why this device is necessary for this child—including how it will help them stay safe, communicate important needs, and participate as fully as possible.

What Are Common Pitfalls in AAC Funding?

• Incomplete paperwork. Even one missing signature or omitted page can lead to a denial.
• Lack of trial data. Insurance needs to see the student has used, or can use, the requested device with success.
• Unclear diagnosis. A generic “developmental delay” is usually not enough. Clear documentation of the specific communication need is required.
• Device not matching diagnosis. The device requested must fit the disabilities described; for example, an eye-gaze device is only justified if the child cannot use touch-based systems.
• Not addressing less expensive options. Insurers want to see that lower-cost (low-tech) solutions were considered and found lacking for daily communication.

The best approach is to work with an SLP and AAC supplier experienced in insurance funding, and to triple-check all forms before submitting.

How Privacy Laws Affect the Insurance Approval Process

When seeking insurance funding for a child’s AAC device, privacy and security are paramount. Two major laws to know are:

• COPPA (Children’s Online Privacy Protection Act): Protects the online privacy of children under 13. Any personal data (including a child’s voice, photo, geolocation, or communication logs) used for insurance documentation or AAC apps must be handled according to COPPA, with clear notice and verifiable parental consent before any data is collected or shared.
• HIPAA (Health Insurance Portability and Accountability Act): Governs how health professionals and device providers handle protected health information (PHI), including therapy reports, device trials, and prescriptions. If your child’s AAC app or device syncs with a clinic or doctor’s office, it likely falls under HIPAA rules, ensuring strict encryption and secure sharing.

Some device vendors may also require forms of consent or privacy disclosures for cloud backup features, diagnostics, or troubleshooting logs. Confirm all privacy practices and never send identifiable recordings or health info without proper consent and encryption.

Does Insurance Cover Both High-Tech and Low-Tech AAC?

Usually, insurance only covers dedicated, high-tech speech-generating devices, those that meet “durable medical equipment” guidelines and are programmed for voice output. Low-tech (simple picture boards, PECs books, single-message devices) are rarely funded by insurance, as they are considered low-cost, easily replaced, and sometimes can be made in school or by therapists.

Some states or insurers may make exceptions if medical necessity is clearly documented, but generally you will need to seek school funding, grants, or non-profit assistance for non-electronic AAC.

What To Do If Your Claim Is Denied

Insurance denials are unfortunately common. The most frequent reasons include “lack of medical necessity,” missing paperwork, or the insurer stating the device is “educational” rather than “medical.” Do not give up! You may:

• Request written clarification of the denial reason
• File an appeal with new/additional data and supporting statements from both your SLP and physician
• Ask your device supplier for funding support, they often have appeal experts on staff
• Explore secondary insurances, Medicaid waivers, or state-specific equipment funds while appealing

Successful appeals present strong, individualized evidence that without the AAC device, the child experiences serious barriers to health, safety, and basic participation and not just learning.

Additional Grant and Alternate Funding Resources

If insurance coverage is unavailable or only partially covers the device, families can seek:

• State assistive technology programs
• Non-profit grants (United Healthcare Children’s Foundation, AAC-specific foundations, local disability alliances)
• School district funding for in-school use
• Medicaid waiver programs (Home and Community-Based Services, some state-specific aid)
• Device manufacturer/supplier financial assistance programs

These resources are ideal for covering co-pays, denied claims, or accessories not covered by insurance (mounts, cases, extra chargers, etc.).

Frequently Asked Questions About AAC Device Insurance Coverage

1. What if my child already has an iPad, will insurance cover the app?
Most insurers only cover “dedicated” AAC devices that cannot run non-communication apps, to avoid funding general-use tablets. Some states and insurers may allow iPads if they are locked for exclusive AAC use and prescribed for medical reasons. AAC apps for personal tablets are usually considered out-of-pocket expenses.

2. How long does the approval process for an AAC device take?
When paperwork is complete and all reports are submitted promptly, approvals can take several weeks to a few months. Appeals can add more time. Planning ahead and responding quickly to insurer requests is essential.

3. Can I use the school’s device at home, or do I need my own?
School devices are typically for school use only, and may not be available evenings, weekends, or during holidays. A personal, insurance-funded AAC device is essential for full communication access across all environments.

4. Are AAC device accessories (mounts, cases) covered by insurance?
Some insurance plans may cover a basic mount or case if medically justified (for wheelchair mounting or physical access). More often, families secure these through grants, manufacturers, or out-of-pocket spending.

5. What if I move to another state? Can my child keep coverage for their AAC device?
Medicaid and private insurance coverage rules are state-dependent. Once approved, devices are property of the child/family, but future repairs, upgrades, or replacements may require new approval under your new state’s program. Contact your insurer before moving to arrange for device documentation and ongoing support.

Bottom Line: AAC devices are life-changing for children with speech and communication needs, and insurance can open the door, if teams understand the process, prioritize privacy, and document every step. With a knowledgeable SLP, strong documentation, and support from the right partners, families can turn “no” into “yes” and give every child the power to be heard.