How to pay for an AAC or eye-gaze communication device
The main ways to pay for a speech-generating device are Medicaid, private insurance, and your child's school, with grants and state loan programs filling the gaps. Start with one document: a formal evaluation from your child's speech-language pathologist.
Last verified: September 2026
Teagan, who inspired this nonprofit, is nonverbal and talks with an eye-gaze device, so this guide is personal to us. It is general information, not medical or legal advice. Please confirm every detail with the agency, plan, or program named.
The short answer
Book the SLP evaluation now. It documents why your child needs a device, and Medicare requires it before a device is delivered.
Use the phrase "speech-generating device." Medicare treats these devices as durable medical equipment, and the billing codes start at E2500.
If your child is under 21 and on Medicaid, ask about EPSDT. States must cover medically necessary equipment for children even when the adult plan does not.
Ask the IEP team to consider assistive technology. Federal law requires the team to consider it, and IEP services are provided without charge to you.
Borrow a device while you wait. Your state AT program lends devices for short-term trials.
First, learn the words the system uses
AAC means augmentative and alternative communication. Payers rarely use that term. Medicare's national coverage policy calls these tools speech-generating devices (SGDs) and defines them as durable medical equipment that gives a person with a severe speech impairment the ability to meet functional speaking needs. Source
Medicare handles eye-gaze as an accessory. Its policy article describes an "ocular tracking device" as an SGD accessory that lets a speech-impaired person use their eyes to communicate, billed under code E2599. Source Knowing these terms helps your call land in the right department.
Medicare does not pay for features that are not about communication. Its national policy says software or hardware used to create documents and spreadsheets or play games or music is not covered. Source
Where the money comes from
Funding paths at a glance
Many children qualify for more than one path. Families often layer them, for example a school device for class, a medical device through Medicaid or insurance, and a grant to cover what is left.
Public coverageWorth asking about
Medicaid (EPSDT benefit)
Who it is for
Children under 21 who are enrolled in Medicaid.
What it can help with
Medically necessary services in the federal 1905(a) categories, which include medical equipment, supplies, and appliances. States must cover them for children even when the adult state plan does not.
How you get it
Apply through your state Medicaid agency. Your child's providers then request the device, and the state may require prior authorization.
Children covered by an employer or individually purchased health plan.
What it can help with
Plans set their own rules for speech-generating devices. Ask for the plan's written coverage criteria and prior authorization steps.
How you get it
Ask the plan which documents it requires, such as a prescription or an evaluation. If denied, you have the right to an internal appeal and an external review.
People with Medicare Part B who have a severe speech impairment and meet the coverage criteria.
What it can help with
Speech-generating devices as durable medical equipment, plus eye tracking and gaze interaction accessories when there is a demonstrated medical need. After the Part B deductible, you pay 20% of the Medicare-approved amount.
How you get it
Formal SLP evaluation, then a written order from the treating practitioner, through a Medicare-enrolled supplier.
Children with disabilities who receive special education under an IEP.
What it can help with
Assistive technology devices and services, including evaluation, acquiring the device, customizing and repairing it, and training for your child and family. Home use is required case by case when the IEP team finds it is needed.
How you get it
Ask the IEP team, in writing, to evaluate your child's assistive technology needs. The team must consider whether your child needs AT.
Infants and toddlers with disabilities in your state's early intervention program.
What it can help with
Assistive technology devices and services are early intervention services. They are provided at no cost unless federal or state law sets up a system of family payments, such as sliding fees.
How you get it
Ask your early intervention service coordinator to add AAC to your child's plan.
Children 18 or younger under the care of a licensed medical provider, within household income limits that depend on the number of dependent children.
What it can help with
Lists communication devices and assistive technology among covered equipment. Requests must not be covered by existing insurance. One grant per child every 12 months, paid directly to the provider or company.
How you get it
Online application on a monthly cycle. The deadline is the 15th of each month.
Children 16 or younger whose primary insurance is a commercial health plan, within income limits by family size. UHCCF says secondary coverage through Medicaid or CHIP is acceptable.
What it can help with
Medical expenses not covered, or not fully covered, by the family's commercial insurance. Awards are limited to $5,000 in a 12-month period and $10,000 per lifetime, and grants are for medical costs incurred within 90 days. Confirm on its site that your item qualifies.
How you get it
Online grant application. Payment goes to the provider or reimburses the family with documentation.
Answer three quick questions and we will highlight the funding paths above that are worth a call. This is only a starting point. Each agency, plan, school team, and foundation makes its own decision.
Your plan
How to apply, step by step
1
Ask for a formal AAC evaluation
Ask your child's speech-language pathologist (SLP) for a formal evaluation for a speech-generating device. Medicare requires one before delivery, and its rules spell out what a strong report covers: the type and severity of the impairment, why natural speech cannot meet daily needs, functional communication goals, why this device and these accessories were chosen, a training plan, and your child's ability to use it. Medicare also says the evaluating SLP may not be employed by or financially tied to the device supplier. Source
2
Borrow before you choose
Look up your state AT program in the AT3 Center directory and ask about a device demonstration or short-term loan, including eye-gaze options. Trying a device is how you and your SLP learn what truly works. Source
3
Submit through your coverage
For Medicaid, your state Medicaid agency is the place to apply, check eligibility, and ask about claims. Medicaid.gov lists every state agency with its phone number: find your state Medicaid agency. For private insurance, call member services on your child's insurance card and ask for the plan's written criteria for a speech-generating device.
4
Raise it at the IEP or early intervention meeting
At the same time, ask the school team to consider assistive technology, which it is required to do, or ask your early intervention coordinator. Source
5
If the answer is no, appeal
Medicaid: you have fair hearing rights, and the written denial must explain how to request a hearing. Source Private insurance: file an internal appeal within 180 days of the denial notice. For a service you have not received yet, the plan must decide within 30 days, and you can ask for an external review by an independent third party. Source
6
Fill the gap with grants
Keep every denial letter and itemized quote. First Hand Foundation asks for an insurance denial letter, an itemized quote, income verification, and a specialist evaluation when applicable. Source You can also apply to Teagan's Crown for help.
None of the official sources we checked describe a single waiting list for speech-generating devices. The waiting happens in steps: getting the evaluation, getting prior authorization, and appealing if the first answer is no. We will not guess how long each step takes where you live, because it varies and no official source we checked publishes a number.
Here is what the official rules do say:
Medicaid for children. CMS says prior authorization and other utilization controls may not delay needed treatment, and decisions must be made and shared with you and the provider promptly. Source
Private insurance. An internal appeal for a service you have not received yet must be decided within 30 days. In urgent cases, an expedited appeal must be decided as quickly as your child's condition requires, and at least within 4 business days. Source
First Hand Foundation. Applications close on the 15th of each month, and applicants hear back by the end of that month. Source
Medicaid waiver waiting lists. This is the one real waiting list many families meet. CMS is clear that a Medicaid-enrolled child on a home and community-based services (HCBS) waiver waiting list is still entitled to EPSDT, and states cannot deny Section 1905(a) services because the child is on that list. So do not wait for a waiver slot to ask for a device. Source Our waiver finder and resources hub can help you learn your state's waivers.
Why start now, even if you are unsure? Medicare requires the SLP evaluation before a device is delivered, and First Hand Foundation asks for a specialist evaluation when applicable, so it is a useful first document to have. A device loan from your state AT program can give your child a voice while the paperwork moves. And appeal clocks start from the date of a denial notice, such as the 180-day limit for a private insurance internal appeal, so a head start matters.
What to say when you call
A suggestion, not a required script. Adjust it to fit your child.
"Hi, my name is ____. I am calling about my child, ____, member ID ____. My child has a severe speech impairment and cannot meet daily communication needs with speech alone. Our speech-language pathologist is recommending a speech-generating device, with an eye-tracking accessory.
Can you tell me what your plan requires to approve it? I would like the coverage criteria in writing, the prior authorization steps, and which suppliers I can use. If this is denied, please send me the denial in writing with the reason and my appeal rights. Can I have a reference number for this call?"
Documents to gather
The SLP's formal AAC evaluation report
The prescription or written order from your child's doctor
A letter explaining medical necessity
Insurance and Medicaid cards, front and back
The supplier's itemized quote
Every denial letter and appeal notice
Your child's current IEP or early intervention plan
Proof of income, such as a tax return or W-2, for grants
Keep a call log
Date and time of every call
Name of the person you spoke with
Reference or case number
What they said, and what happens next
Any deadline they mention
Every child's path is different. Families of children with cerebral palsy, autism, and Down syndrome can find more condition-specific help in our guides.
Frequently asked questions
Does Medicaid cover AAC and eye-gaze devices for children?
For children under 21 who are enrolled in Medicaid, the EPSDT benefit requires states to cover all medically necessary services within the federal Section 1905(a) categories, including home health services with medical equipment, supplies, and appliances, even if the state plan does not list the item for adults. The state decides medical necessity case by case, and CMS says flat or hard limits such as budget caps may not be applied to EPSDT-eligible children. Ask your state Medicaid agency how it handles speech-generating devices.
What are the billing codes for speech-generating devices?
Medicare's local coverage determination L33739 lists E2500, E2502, E2504, E2506, E2508, E2510, and E2511 as speech-generating devices. Its policy article says E2511 is for speech-generating software on a general computing device such as a tablet, and uses E2512 for mounting systems and stands, E2513 for an electromyographic sensor accessory, and E2599 for other separately payable accessories, and names an ocular tracking device as one E2599 example. Other payers may use these codes too, so ask your plan which ones it uses.
Does Medicare cover eye-gaze accessories?
Medicare's local coverage determination L33739 states that eye tracking, gaze interaction, and electromyographic sensor accessories for speech-generating devices are covered when furnished to individuals with a demonstrated medical need for such accessories. The need must be documented in the speech-language pathologist's formal evaluation.
Can my child's school provide an AAC device?
Yes, if the IEP team finds your child needs it. Under IDEA, each public agency must make assistive technology devices and services available when they are required as part of a child's special education, related services, or supplementary aids and services. The IEP team must consider whether the child needs assistive technology, and use of a school-purchased device at home is required case by case if the team decides the child needs it to receive a free appropriate public education.
Can the school make me use my insurance or Medicaid to pay for it?
Not without your consent. Under 34 CFR 300.154, a school may not require you to sign up for public benefits, may not require you to pay out-of-pocket costs such as co-pays when it files a claim, and must get your written consent before it first accesses your child's public benefits. It must ask your consent each time it wants to use private insurance, and your refusal does not end its duty to provide required services at no cost to you.
What if Medicaid denies the device?
You have the right to a fair hearing. CMS says a written denial must state the decision, the specific reasons, the rules it relied on, and how to request a fair hearing, including an expedited hearing. You may represent yourself or bring a relative, friend, lawyer, or other spokesperson, and you may review your case file before the hearing. If your child's Medicaid is through a managed care plan, CMS says you must first use the plan's appeal process before requesting a state fair hearing.
Are there grants that pay for communication devices?
Yes, a few national programs we checked are active. First Hand Foundation lists communication devices and assistive technology among the equipment it funds for children 18 and younger. The UnitedHealthcare Children's Foundation helps children 16 and younger with medical costs their commercial insurance does not fully cover. Variety - the Children's Charity says it grants items and services that provide communication, and its site helps you find a local chapter. Each has its own rules, so read them on the official site.
Where can we borrow or try a device before buying?
Every state, the District of Columbia, Puerto Rico, and the outlying areas has a federally funded Assistive Technology Act program. These programs offer device demonstrations, short-term device loans, device reuse, and financing options. Find yours in the AT3 Center state directory.
Sources
We used only these official pages. Rules change, so please confirm details with the agency, plan, or program before you act.