I was diagnosed with ALS in January 2008 and am facing the same issues as I've read in this post. I have the added burden of being a US citizen living in Germany with American insurance. All items which provide assistance such as bathroom rails, bathtub lifting devices and all other devices which allow limited mobility would be paid for by German insurance but is not covered by my American insurance. Even know I am a legal resident in the state of Illinois I cannot receive state assistance because I'm not physically living in the state. Likewise, I cannot rent or borrow equipment from local ALS chapters, because I'm overseas, and there are no such programs here in Germany. Matters are complicated by the fact that the dollar is doing so poorly against the euro. Not only must I buy devices that at inflated prices, but I also lose with the exchange rate. The same is true with my medical coverage. My insurance pays for 90% of all medications and outpatient care, but with the exchange rate I do not receive enough reimbursement to even cover those expenses without paying out of pocket. To move my German wife and family back to the United States for the few years I have would create even more financial burden, which we simply cannot afford. As of yet I have not found a solution to any of these issues, nor have I been able to find a way of offsetting or mitigating the costs associated with ALS. If and when I do, I will post my findings