This practice, which occurs in somewhat different form in Medicaid, results in far more expense to the programs for the devices, and shows the real lack of commitment by both medicare and medicaid to independence and choice for people with chronic disabilities or medical conditions. If they could do it, they would restrict the use of communications devices to only medical personnel.....
http://goo.gl/xQwAjNHistorically, Medicare has covered 80 percent of the cost for basic speech-generation devices, the machines many ALS patients use. Those patients could pay out of pocket for upgrades that allow the devices to connect to the Internet and perform services such as opening doors. But in February, the Centers for Medicare and Medicaid Services (CMS) posted a “coverage reminder” noting that the program does not cover the cost of upgradable devices. In other words, Medicare only will cover the cost of the basic speech-generation device — not those that can be upgraded to perform tasks beyond speech generation or perform functions not considered medical.