At times, a student's need for AT may be both educationally and medically necessary, as in the case of a child with cerebral palsy who uses a communication device throughout the course of the day. In this circumstance, the family may wish to pursue funding for the device through their insurance(Medicaid and Private Insurance). In fact, Medicaid is considered the "payer of first resort" for students who are Medicaid beneficiaries (i.e. the payment source that should be pursued first, prior to seeking other forms of reimbursement). A school cannot require a family to access their insurance as a funding source. Families, however, may prefer this option because the child owns the device if it is purchased through health insurance; the school owns it if the school buys it. Regardless of the payment source, the school is ultimately responsible for ensuring that the student has access to all devices/services on the IEP in a timely fashion.

In addition, a student cannot derive educational benefit from a malfunctioning device. Thus, in most cases, school districts are obliged to pay for repairs, replacement batteries, or other services needed to keep a device in good working order. If the device needs to be returned to a manufacturer for repair, the school must ensure that the child has access to comparable supports in its absence. (Note: recent IDEA regulations create exceptions to this obligation with respect to surgically implanted devices, such as Cochlear implants.)

Another option for some families is to acquire a needed or desired device through the Massachusetts Assistive Technology Loan Program (MATLP). If a school district does not consider a device necessary (including after appeal), and the device is not medically necessary, the MATLP is a loan program that can help families acquire needed devices with better interest rates than traditional bank loans, and repayment lengths based on the expected useful life of the device purchased.