{"id":10707,"date":"2015-09-21T17:21:13","date_gmt":"2015-09-22T00:21:13","guid":{"rendered":"http:\/\/www.speechbuddy.com\/blog\/?p=10707"},"modified":"2023-11-08T10:30:13","modified_gmt":"2023-11-08T18:30:13","slug":"speech-therapy-insurance-is-it-covered","status":"publish","type":"post","link":"https:\/\/www.speechbuddy.com\/blog\/financial-resources\/speech-therapy-insurance-is-it-covered\/","title":{"rendered":"Speech Therapy & Insurance: Is Speech Therapy Covered?"},"content":{"rendered":"

Q:\u00a0Will speech therapy be covered by my insurance?<\/h3>\n

That is an excellent question, but one without an easy answer. As consumers, we logically expect that our health plans should cover therapeutic services such as speech and language therapy. But this is not always the case. Our goal in this article is to help you find the best path to answering those important speech therapy insurance questions for your family.<\/p>\n

<\/p>\n

Photo\u00a0Untitled (Maya Gouw)<\/a> by\u00a0Korean Resource Center<\/a><\/span><\/p>\n

\"Is<\/a>

Flowery Insurance<\/a> by Jamie<\/a><\/p><\/div>\n

Insurance coverage is a complicated topic, mostly because the answer is never the same, and with speech therapy, insurance is no different. Every insurance company handles reimbursement differently, and every plan within the company has different benefits! Some require preapproval, others don\u2019t. Some require a physician\u2019s referral (most HMO plans do), others don\u2019t (most PPO plans do not). Some have unlimited benefits, others have limited or no benefits. Unfortunately, there is not a linear path to learning the answer for your family. That said, we are here to help you navigate through the stream and will help you find the answer your family needs to move forward.<\/p>\n

The good news for many families is that speech therapy is generally a covered benefit\u00a0when a patient has an acute illness or injury<\/strong><\/em> that requires speech therapy as part of the rehabilitation process.\u00a0If a child is born with cleft lip or palate, speech therapy would usually be covered. The same goes for TBI, stroke, etc. When speech or language impairment is an adjunct indication to a major medical event, then speech therapy would often be a covered benefit.<\/p>\n

The challenge lies, however, when speech or language impairment is not associated with an acute major injury or condition. Most insurance companies may exclude disorders that are considered \u201cdevelopmental\u201d<\/strong><\/em> or \u201cchronic\u201d in nature. When a child experiences speech delay<\/strong><\/em>, has an articulation disorder<\/strong><\/em> (has a lisp<\/strong><\/em>, or cannot correctly pronounce the R sound), experiences phonological processing challenges or apraxia of speech, speech therapy may not be a covered benefit or the coverage may be limited.<\/p>\n

Hidden Benefits: Speech Evaluation & Early Intervention<\/h2>\n
\"Hidden<\/a>

Hide and Go Seek<\/a> by Chris McBrien<\/a><\/p><\/div>\n

A few important notes: First, very often a speech \u201cevaluation\u201d or \u201cassessment\u201d would be covered, even if ongoing therapy is not covered. If that\u2019s the case for your plan – start there! When you have your child meet with an expert speech therapist, she can help guide you and recommend a treatment path for your child. You can then present this plan to your insurance company as the result of your evaluation and understand what your benefits will cover. Next, if your child is under the age of 3, you may qualify for free services through your State called Early Intervention. Here is the contact information of Early Intervention Programs in every state<\/a>.<\/p>\n

When looking at your health plan, there are some key areas to look at to understand your coverage:<\/p>\n