Ways to pay for AlwaysHere without paying full price out of pocket.

An ABLE account is a tax-advantaged savings account for a person with a disability. Money grows tax-free and comes out tax-free when it pays for "qualified disability expenses." Federal law lists assistive technology, health, prevention and wellness, and oversight and monitoring as qualified expense categories. The AlwaysHere subscription is a reasonable fit for those categories.

Who qualifies (2026)

• The person's disability or condition began before age 46. This changed on January 1, 2026 (it used to be before 26), so many more people qualify now.
• They get SSI or SSDI because of that disability, or a doctor has diagnosed a qualifying condition (the person self-certifies when opening the account).
• Most autism and intellectual/developmental disability qualify. Most dementia does not, unless it was early-onset before 46.

Key numbers

• Anyone (parents, grandparents, friends) can contribute. The 2026 total limit is $20,000 per year per account, with more allowed for account owners who work.
• The first $100,000 in an ABLE account doesn't count against SSI. Qualified spending doesn't affect Medicaid.
• Some states give a state income tax deduction for contributions. Illinois allows up to $10,000 (single) or $20,000 (joint). California does not.

How to use it for AlwaysHere

1. Open an account. Many state plans accept out-of-state residents. Start at ablenrc.org to compare plans (in Illinois, IL ABLE; in California, CalABLE).
2. Pay AlwaysHere with the ABLE debit or prepaid card, or have the plan send payment.
3. Keep your itemized AlwaysHere receipts with your ABLE records. Email support@alwayshere.app for monthly or annual receipts.

Illinois families: IL ABLE is switching platforms. The last day to use the current debit card or checks is Oct 9, 2026; accounts are frozen Nov 5–10, 2026; a new prepaid Visa card follows.

If your loved one has a special needs trust, the trustee can pay AlwaysHere directly. Never give cash to the beneficiary.

• SSI: Since September 30, 2024, only shelter counts as "in-kind support." A subscription the trust pays directly does not reduce SSI.
• First-party (self-settled) trusts must spend only for the beneficiary's sole benefit. Explain that AlwaysHere supports the beneficiary's routines, independence, and safety.
• Third-party trusts (funded by parents or relatives) usually have the most flexibility.
• Use the Trustee Request Letter in the templates below.

These accounts pay medical expenses with pre-tax money. The IRS standard: the expense must be primarily to alleviate or prevent a physical or mental disability or illness, not for general wellness (IRS Publication 502). There is no IRS ruling on AI companion services specifically, so eligibility is not guaranteed.

How to make the strongest case

1. Ask your loved one's doctor (primary care, neurologist, psychiatrist, or developmental pediatrician) to complete the Letter of Medical Necessity template below. It ties AlwaysHere's medication and routine prompts, check-ins, and caregiver alerts to a diagnosed condition.
2. Pay for AlwaysHere, then submit the letter and the itemized receipt to your plan administrator.
3. HSA: You generally decide yourself and keep the letter and receipts in case of an IRS question. FSA/HRA: The administrator decides. Some will ask for a letter every plan year.

Tip: Describe AlwaysHere by what it does for the condition (medication reminders, routine prompts, orientation cues, alerting a caregiver). Plans reject "companionship" or "wellness" descriptions.

The person whose expense it is must generally be you, your spouse, or your tax dependent. Adult children with disabilities often still qualify as dependents; ask your tax preparer.

These cover care that keeps a qualifying person safe and protected so you can work or look for work. A qualifying person includes a spouse or dependent of any age who is physically or mentally unable to care for themselves and lives with you more than half the year (IRS Publication 503).

• Starting 2026, employers can offer a Dependent Care FSA of up to $7,500 per household per year.
• AlwaysHere's scheduled phone call check-ins and caregiver alerts while you are at work may qualify as care for "well-being and protection." This is a judgment call with no specific IRS guidance, so ask your administrator first.
• Don't claim the same payment on both a health FSA/HSA and a dependent care account or credit.

If you itemize deductions, unreimbursed medical expenses above 7.5% of your adjusted gross income are deductible on your federal return. The same "primarily for a medical condition" test from section 3 applies, and a Letter of Medical Necessity helps. Talk to your tax preparer. You can't deduct amounts already paid from an HSA, FSA, ABLE account, or trust.

This is often the best option for dementia families who hold a policy.

• Cash or indemnity policies pay a set amount once benefit triggers are met (usually help with 2 or more daily activities, or cognitive impairment). You can generally spend that money on anything, including AlwaysHere.
• Reimbursement policies pay only for listed services. Many include an "Alternate Plan of Care" clause that lets the insurer cover services not listed in the policy if the insurer, doctor, and family agree it helps. Ask for it by name.
• Life insurance or annuity policies with a long-term care rider often work like cash policies.
• Use the Insurance Request Letter in the templates below.

• Veteran-Directed Care: Eligible veterans get a flexible monthly budget and choose their own goods and services. A local Area Agency on Aging, Aging and Disability Resource Center, or Center for Independent Living runs it with the VA. Ask the VA social worker for a referral and request AlwaysHere in the spending plan.
• Program of Comprehensive Assistance for Family Caregivers: a monthly stipend paid to the family caregiver of an eligible veteran. The family decides how to spend it.
• VA assistive technology: VA can provide cognitive-support technology through a provider consult. Ask the veteran's VA care team.

Every county is served by an Area Agency on Aging that runs the federal National Family Caregiver Support Program. You don't need Medicaid. It serves:

• Caregivers of someone age 60 or older
• Caregivers of someone with Alzheimer's or another dementia, at any age
• Relatives age 55 or older caring for an adult (18–59) with a disability (for example, an aging parent of an autistic adult)

Besides respite and counseling, programs can pay for "supplemental services" on a limited basis. Each agency sets its own limits. Some states go further: Pennsylvania's Caregiver Support Program can reimburse eligible caregivers up to $600 a month for caregiving costs.

How to start: call the Eldercare Locator at 1-800-677-1116 or visit eldercare.acl.gov to find your agency. Ask for a caregiver assessment and ask whether supplemental services or caregiver reimbursement can help pay for AlwaysHere. Use the Area Agency on Aging Request Letter in the templates below.

Lake County, Illinois: the caregiver program is run by Bacoa, (847) 381-5030. Ask about "gap-filling" and "ADRD supportive gap-filling" for dementia caregivers. California: also contact your local Caregiver Resource Center (caregivercalifornia.org).

If your loved one already gets home and community-based services (a Medicaid waiver), and especially a self-directed budget, ask their case manager or service coordinator whether AlwaysHere can be added to the plan. Depending on your state, it may fit under assistive technology, enabling technology, or individual-directed goods and services.

1. Ask for AlwaysHere to be considered at the next planning meeting (or ask for a meeting sooner).
2. Tie it to specific goals using the Plan Goal Language template below, such as taking medications on time, completing morning routines independently, or getting help faster when something goes wrong.
3. For self-directed budgets, the fiscal agent pays AlwaysHere's invoice. We provide a W-9, invoices, and a service description on request.
4. If you are turned down, ask for the decision in writing. You usually have appeal rights with short deadlines.

Examples: California's Self-Determination Program, Wisconsin IRIS, Ohio waiver assistive technology (which allows subscription fees), and Veteran-Directed Care. Approval is up to your state and plan.

Important: If your loved one gets paid in-person supervision hours (for example, IHSS protective supervision in California), don't describe AlwaysHere as a replacement for supervision. It adds support; it does not replace a person.

Not on a waiver yet? Waitlists are long in most states (in Illinois, about four years). Get on the list now (in Illinois, call 1-888-DD-PLANS for PUNS; in California, contact your regional center) and use options 1–8 in the meantime.

• ACT Today (Autism Care Today): grants of up to $5,000 for autism families, with no stated age limit. Applications open quarterly. See act-today.org.
• Alzheimer's Association local chapters: some offer caregiver respite grants. Call 1-800-272-3900.
• Local Arc chapters, Lions Clubs, and community foundations sometimes fund technology for individuals.
• Grants are usually one-time. Ask AlwaysHere for a 12-month prepaid invoice to attach to your application.

• Vocational Rehabilitation: your state VR agency can pay for technology that helps someone get or keep a job (job-day reminders, schedules). It must be written into their employment plan.
• Impairment-Related Work Expenses (IRWE): if your loved one works and gets SSI or SSDI, what they pay for disability-related items needed to work can be subtracted from their countable earnings.
• Plan to Achieve Self-Support (PASS): lets someone on SSI set money aside toward a work goal. Ask a benefits counselor (WIPA program: 1-866-968-7842).