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AT Funding - AT Funding Guide - Public (Medicaid, Medicare) & Private Insurance

Delaware Assistive Technology Initiative

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Public & Private Insurance

Medicaid of Delaware   |  Medicare  |  Private Insurance  

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Private insurance is any health insurance policy purchased by an employer or by an individual from a private insurance company.

Public insurance is an insurance plan or policy that is subsidized by federal or state funds (Medicaid, Medicare). To be eligible for these plans an individual must meet one or more qualifying criteria involving age, income level, and health status.

Throughout this section, we will be discussing both public and private insurances. Insurance coverage goes by different names: we will refer to private insurance as an insurance policy. Medicaid coverage is dictated by a State Plan, and Medicare coverage is determined by national Medicare Policy. For simplicity in this section, we will refer to all three as a “policy.”

Individuals may be covered by a single insurance policy or by multiple policies. While there is considerable variability among what health insurance companies and state and federal plans cover with regard to AT, keep these general considerations in mind when dealing with public and private insurance.

Private insurance is often overlooked when efforts are made to obtain AT for persons with disabilities. If one has private insurance, Medicare and Medicaid consider that insurance to be the "payor of first resort," and will not consider funding requests until an individual's private insurance has denied all or part of the claim. There are three main questions when one looks to any insurance to fund AT:

Know the Policy

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Know the Process for Obtaining AT

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Coordinate Insurance and Other Benefits

Graph depicting the order in which sources must be tapped.

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Appeal Denials

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