MailChimp Header Pop-up Form Code

Funding

Eyegaze Inc. works with Medicare, Medicaid and private insurance. Navigating insurance can be confusing and frustrating, so we have a dedicated advocate on hand to help.
Learn More
Funds

Finding the Right Insurance Provider

There are many different insurance providers who all offer different levels of coverage. These are also different from plans that may be offered through your employer or state-specific Medicaid.

We can help you find the best source of funding. To begin making inquiries, we need to get an accurate estimate of your financial responsibility to purchase a device.

Potential Sources of Funding

Medicare

Medicaid

Employer

Private Insurance

Intake

Funding Request Process

l

Fill out the following forms

Please complete and return the following documents to Eyegaze Inc. for specific plan benefits.

Click on each document to the right to download them.

 

SLP Report
A communication evaluation by a speech-langauge pathologist needs to document the need for a communication device.

l

Retain for your records

Keep these documents on hand for your records.

  • Privacy Practices
  • DMEPOS Standards

How to Submit Required Documents

Send all completed paperwork to Eyegaze Inc. via fax or mail.

Mailing Address

Eyegaze Inc.
Funding Dept.
10363 Democracy Lane
Fairfax, VA 22030

Fax Number

(703) 385-7137

Easy to use, accurate, and trustworthy

Learn why the Eyegaze Edge® is the eye-tracking device of choice