Assistive Devices means any category of durable medical equipment, mechanical apparatus, electrical appliance, or instrument of technology used to assist and enhance an individual’s independence in performing any activity of daily living.
- Adaptive equipment for eating (i.e. utensils, trays, cups, bowls that are specially designed to assist an individual to feed him/herself).
- Specially designed clothes to meet the unique needs of the individual with the disability (e.g. clothes designed to prevent access by the individual to the stoma, etc.).
- Purchases, rentals, repairs covered by OHP for durable medical equipment after OHP limit has been reached.
- Limit of $5000 per year without ODDS approval
- Any single device or assistance costing more than $500 in a plan year must be approved by ODDS.
- For assistive devices that may be available through the OHP, a request to exceed the limits of the health plan and the denial must be documented before the assistive device may be purchased with K plan funding.
- If the OHP or a private insurance will pay for an item but the maximum allowable rate will not cover the specific type or brand of item desired, Department funds cannot be used to make up the difference in cost. Individuals should consult with their health plan staff, such as the Exceptional Needs Care Coordinator, if they have difficulty locating an item for the maximum allowable rate.
This service is not available for:
- Work-related items available through a Vocational Rehabilitation employment plan.
- Generic household furnishings, personal clothing (for individual or family), and other purchases made because of financial need.
- Materials or equipment that have been determined unsafe for the general public by recognized consumer safety agencies.
- Items which are needed solely to allow a school-aged individual to participate in school.
- Items not of direct medical or remedial benefit to the individual.
Source: In home Expenditure Guidelines Version 2.0 Effective for all ISPs authorized for implementation TBD/2014