Updated: Oct 25, 2022
Our daughter was three years old before we seriously considered getting her a speech generating device (“SGD”). The device had been mentioned as an option by our ST, and I’d briefly looked into it. As our daughter approached her third birthday, I started to see on various social media posts that other parents with nonverbal children were getting their children speech devices at 24 months old. I talked with our ST about it (worried we were behind), and she agreed that it was a good time to get started and was going to suggest it herself.
It is important to speak with your child’s ST about SGDs and when an introduction to such a device is appropriate. Getting an early start on teaching your child to use a SGD can help with communication and independence and help curb frustration and related obstacles down the line, including decreasing related behavioral problems.
We completed the SGD evaluation and determined that the Tobli Dynavox EM-12 seemed like the best fit. My daughter loves to “swipe,” so the iPad was a no go. She would swipe the screen, and we’d lose our place. The TD, however, wasn’t as sensitive. Our ST and the TD rep worked together to get the insurance claim prepared. The device was going to cost $7,945.
Yes, you read that correctly. $7,945.
You are probably thinking the same thing I was, WHY ON EARTH DOES IT COST THAT MUCH?!?! One of the problems is that health plans require that SGDs be a “dedicated” device. A dedicated device means that it cannot have any other functionality (i.e., the software must be limited to use for speech generation, without music, apps, or other features). Okay, so there is some limited tinkering involved to limit the device from accessing non-speech generating functions. This still didn’t explain the mark-up.
During this process, I learned more about the TD EM-12 and other SGDs. The TD EM-12 is simply a Microsoft Surface Pro loaded with the TD Snap App and protected with a rugged case. SGDs are all basically a Surface or an iPad with an app and a case. So, technically, you could go out and buy your child an SGD without having to jump through the hoops of insurance. But, if you have great insurance, or otherwise couldn’t afford the products directly, it might make sense to take the insurance route.
The decision whether to go through insurance or to buy the SGD directly is a simple (sort of) cost evaluation. For us, our insurance covered all but $759 (90% of the total cost). Had we chosen to purchase the Surface (a Surface Pro 8 starts at $939), plus the TD Snap App ($50), and a protective case (approx. $100) we’d be looking at between $1,089. The calculations may differ significantly based on how much your insurance will cover, which device you purchase, and whether you can obtain a discounted device (e.g., through employee discounts, sales, or other programs).
What’s remarkable about this is that SGD companies are marking up products – needed for individuals with disabilities to communicate – by 7x. That’s a 700% mark-up! Standard business mark-ups are in the 50% range. This is just another example of our broken health care system.
For us, we saved $330 by going through our insurance, instead of purchasing directly, even with this ridiculous mark-up because, for some reason, our insurance company is willing to pay this hefty amount (it appears) for no other reason than to ensure that the speech device is a “dedicated” device without other apps installed.
Compare your insurance coverage to the direct purchase price to make sure you’re getting the best deal. It might be significantly cheaper for you to buy the device, app, and case directly.
Keep in mind that if you buy directly, you will still want that device to be a dedicated SGD (i.e., not to be used for games, videos, reading, etc.). Talk to your child’s ST about why.