{"id":12,"date":"2012-01-31T16:17:43","date_gmt":"2012-01-31T16:17:43","guid":{"rendered":"http:\/\/www.speechbuddy.com\/blog\/?p=12"},"modified":"2015-02-18T09:26:18","modified_gmt":"2015-02-18T17:26:18","slug":"demystifying-healthcare-coverage","status":"publish","type":"post","link":"https:\/\/www.speechbuddy.com\/blog\/financial-resources\/demystifying-healthcare-coverage\/","title":{"rendered":"Demystifying Healthcare Coverage"},"content":{"rendered":"<div id=\"attachment_26\" style=\"width: 310px\" class=\"wp-caption aligncenter\"><a href=\"http:\/\/www.speechbuddy.com\/blog\/wp-content\/uploads\/2012\/01\/speech9.jpg\"><img decoding=\"async\" aria-describedby=\"caption-attachment-26\" class=\"size-full wp-image-26 lazyload\" title=\"Health Insurance Papers\" data-src=\"http:\/\/www.speechbuddy.com\/blog\/wp-content\/uploads\/2012\/01\/speech9.jpg\" alt=\"Health Insurance Papers\" width=\"300\" height=\"300\" data-srcset=\"https:\/\/www.speechbuddy.com\/blog\/wp-content\/uploads\/2012\/01\/speech9.jpg 300w, https:\/\/www.speechbuddy.com\/blog\/wp-content\/uploads\/2012\/01\/speech9-150x150.jpg 150w\" data-sizes=\"(max-width: 300px) 100vw, 300px\" src=\"data:image\/svg+xml;base64,PHN2ZyB3aWR0aD0iMSIgaGVpZ2h0PSIxIiB4bWxucz0iaHR0cDovL3d3dy53My5vcmcvMjAwMC9zdmciPjwvc3ZnPg==\" style=\"--smush-placeholder-width: 300px; --smush-placeholder-aspect-ratio: 300\/300;\" \/><\/a><p id=\"caption-attachment-26\" class=\"wp-caption-text\">Image source: securityworldnews.com<\/p><\/div>\n<p>Does your healthcare plan cover speech therapy? No idea? Ask your employer for the packet or book with the comprehensive explanation of benefits. Check the table of contents for sections labeled something like \u201cSpeech-Language Pathology,\u201d \u201cHearing Care,\u201d \u201cAudiology,\u201d or \u201cSpeech and Language Benefits.\u201d If you don\u2019t see any of these sections, check for a rehabilitation section or an \u201cOther Services and Therapies\u201d section. You may also find hearing and speech assessment coverage listed under diagnostics.<\/p>\n<p><!--more--><\/p>\n<p>Your healthcare policy should spell out exactly which speech-related diagnostic services and treatments are covered in one of these sections. Make a note of whether your healthcare policy covers only speech-language problems that can be attributed to certain causes. Some policies may not cover problems that were present at birth.<\/p>\n<p>It\u2019s also a good idea to check the section labeled \u201cExclusions to Coverage.\u201d This section spells out which services will be denied coverage. If the language is confusing, go to your employer and ask for an explanation, or call the insurance company directly. If you call the insurance company, have them provide a written explanation of your coverage.<\/p>\n<div id=\"attachment_28\" style=\"width: 310px\" class=\"wp-caption aligncenter\"><a href=\"http:\/\/www.speechbuddy.com\/blog\/wp-content\/uploads\/2012\/01\/speech7.jpg\"><img decoding=\"async\" aria-describedby=\"caption-attachment-28\" class=\"size-medium wp-image-28 lazyload\" title=\"Working with Human Resources\" data-src=\"http:\/\/www.speechbuddy.com\/blog\/wp-content\/uploads\/2012\/01\/speech7-300x210.jpg\" alt=\"Working with Human Resources\" width=\"300\" height=\"210\" data-srcset=\"https:\/\/www.speechbuddy.com\/blog\/wp-content\/uploads\/2012\/01\/speech7-300x210.jpg 300w, https:\/\/www.speechbuddy.com\/blog\/wp-content\/uploads\/2012\/01\/speech7.jpg 580w\" data-sizes=\"(max-width: 300px) 100vw, 300px\" src=\"data:image\/svg+xml;base64,PHN2ZyB3aWR0aD0iMSIgaGVpZ2h0PSIxIiB4bWxucz0iaHR0cDovL3d3dy53My5vcmcvMjAwMC9zdmciPjwvc3ZnPg==\" style=\"--smush-placeholder-width: 300px; --smush-placeholder-aspect-ratio: 300\/210;\" \/><\/a><p id=\"caption-attachment-28\" class=\"wp-caption-text\">Image source: personalbrandingblog.com<\/p><\/div>\n<p>Once you know exactly what your healthcare policy does and doesn\u2019t cover, determine whether you have adequate coverage. If you have a comprehensive plan, it should allow you access to all licensed speech-language pathologists, rather than just those in a certain network. It should also not place a lifetime or yearly limit on your benefits.<\/p>\n<p>A comprehensive plan should also pay for most, if not all, of any needed medical devices. The number of reimbursable therapy sessions should not have a pre-set limit. All necessary diagnostic assessments and treatments should be covered, without excluding specific problems. For example, the healthcare policy should not exclude a certain speech disorder because it arises from a neurological condition. And last, but certainly not least, check your deductible or co-pay. If you have a deductible, you\u2019ll end up paying that amount before the policy will cover expenses.<\/p>\n<p>What if the coverage isn\u2019t adequate? Make an appointment with your employer\u2019s human resources department. Depending on your employer, you might make an appointment with a union representative or a benefits specialist. If you work for a small business owner, ask him to sit down with you for a few minutes to discuss your healthcare policy.<\/p>\n<div id=\"attachment_27\" style=\"width: 310px\" class=\"wp-caption aligncenter\"><a href=\"http:\/\/www.speechbuddy.com\/blog\/wp-content\/uploads\/2012\/01\/speech8.jpg\"><img decoding=\"async\" aria-describedby=\"caption-attachment-27\" class=\"size-medium wp-image-27 lazyload\" title=\"Healthcare Policy\" data-src=\"http:\/\/www.speechbuddy.com\/blog\/wp-content\/uploads\/2012\/01\/speech8-300x168.jpg\" alt=\"Healthcare Policy\" width=\"300\" height=\"168\" data-srcset=\"https:\/\/www.speechbuddy.com\/blog\/wp-content\/uploads\/2012\/01\/speech8-300x168.jpg 300w, https:\/\/www.speechbuddy.com\/blog\/wp-content\/uploads\/2012\/01\/speech8.jpg 660w\" data-sizes=\"(max-width: 300px) 100vw, 300px\" src=\"data:image\/svg+xml;base64,PHN2ZyB3aWR0aD0iMSIgaGVpZ2h0PSIxIiB4bWxucz0iaHR0cDovL3d3dy53My5vcmcvMjAwMC9zdmciPjwvc3ZnPg==\" style=\"--smush-placeholder-width: 300px; --smush-placeholder-aspect-ratio: 300\/168;\" \/><\/a><p id=\"caption-attachment-27\" class=\"wp-caption-text\">Image source: foxbusiness.com<\/p><\/div>\n<p>If you know of any co-workers who share the same concerns as you, invite them to attend the meeting with you. Bring a copy of your policy. Make a list of your specific concerns. For example, write down that your insurance only covers a certain number of therapy sessions, or that it limits your access to speech-language pathologists to those in a certain network.<\/p>\n<p>Discuss your concerns with the company representative. Provide him with contact information for your speech therapist and invite him to learn more about the therapy. Anticipate the company representative\u2019s questions. For example, he might ask why your child can\u2019t simply use the services available in the public school system. You can explain that a speech therapist in a hospital or a private practice can provide a greater range of services to suit your child\u2019s needs. If your healthcare coverage isn&#8217;t adequate, you may also need to prepare to <a title=\"Appeal a Rejected Claim\" href=\"http:\/\/www.speechbuddy.com\/blog\/financial\/how-to-appeal-a-rejected-claim\/\" target=\"_blank\">appeal a rejected claim.<\/a><\/p>\n    <span class=\"hs-cta-wrapper\" id=\"\">\n    <span class=\"hs-cta-node \" id=\"\">\n        <!--[if lte IE 8]><div id=\"hs-cta-ie-element\"><\/div><![endif]-->\n        <a href=\"http:\/\/speechbuddy.com\/guides\/communication-challenges\" ><img decoding=\"async\" class=\"hs-cta-img lazyload\" id=\"\" style=\"--smush-placeholder-width: 655px; --smush-placeholder-aspect-ratio: 655\/211;border-width:0px;\" data-src=\"https:\/\/www.speechbuddy.com\/blog\/wp-content\/uploads\/2017\/03\/533600a3-8950-4500-aa3b-fab8818be024.png\"  alt=\"Parent's Guide to Speech & Communication Challenges\" src=\"data:image\/svg+xml;base64,PHN2ZyB3aWR0aD0iMSIgaGVpZ2h0PSIxIiB4bWxucz0iaHR0cDovL3d3dy53My5vcmcvMjAwMC9zdmciPjwvc3ZnPg==\" \/><\/a>\n    <\/span>\n    <\/span>\n    \n","protected":false},"excerpt":{"rendered":"<p>Does your healthcare plan cover speech therapy? No idea? Ask your employer for the packet or book with the comprehensive explanation of benefits. Check the table of contents for sections labeled something like \u201cSpeech-Language Pathology,\u201d \u201cHearing Care,\u201d \u201cAudiology,\u201d or \u201cSpeech and Language Benefits.\u201d If you don\u2019t see any of these sections, check for a rehabilitation [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[9],"tags":[10,11,5,12],"class_list":["post-12","post","type-post","status-publish","format-standard","hentry","category-financial-resources","tag-healthcare-coverage-and-speech-therapy","tag-paying-for-speech-therapy","tag-speech-therapy","tag-speech-therapy-health-insurance"],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/www.speechbuddy.com\/blog\/wp-json\/wp\/v2\/posts\/12","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.speechbuddy.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.speechbuddy.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.speechbuddy.com\/blog\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.speechbuddy.com\/blog\/wp-json\/wp\/v2\/comments?post=12"}],"version-history":[{"count":7,"href":"https:\/\/www.speechbuddy.com\/blog\/wp-json\/wp\/v2\/posts\/12\/revisions"}],"predecessor-version":[{"id":645,"href":"https:\/\/www.speechbuddy.com\/blog\/wp-json\/wp\/v2\/posts\/12\/revisions\/645"}],"wp:attachment":[{"href":"https:\/\/www.speechbuddy.com\/blog\/wp-json\/wp\/v2\/media?parent=12"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.speechbuddy.com\/blog\/wp-json\/wp\/v2\/categories?post=12"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.speechbuddy.com\/blog\/wp-json\/wp\/v2\/tags?post=12"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}