Whether your child is already in speech-language therapy, or you are considering enrolling them, questions of cost and insurance coverage are likely to play in your mind. As policies renew or change with the start of the new year, questions or confusion around coverage may be highlighted. Read on for answers to some FAQs regarding insurance coverage of speech-language therapy.
- Is speech-language therapy covered by insurance?
Speech-language therapy is at least partially covered by most major insurances. Coverage will vary from one plan to the next and may depend on the diagnosis meriting services. Your service provider will seek to find the best coverage available given the diagnosis and treatment provided.
- What out-of-pocket cost can I expect from speech-language therapy?
Until your deductible is met, you can expect to at least pay your copay and/or coinsurance for each visit. Depending on your provider, this cost may be required at the time of service, or billed to you at a later date. Cost estimates beyond your copy/coinsurance can be provided by your therapy clinic. However, these estimates are based on quotes by your insurance company and actual benefits are determined at the time the claim is processed.
- How does my insurance affect the frequency of services?
Some insurance plans cover a set number of visits per year. For this reason, your provider may recommend fewer visits so that they will last longer, or recommend taking a break from services at certain points in the year. These recommendations depend not only on your insurance, but also what is best for your family. The family member receiving speech-language therapy may benefit most from regular, frequent visits, or from more ongoing, long-term support. Whatever your therapy schedule, it is important to continue to work on communication skills outside of the therapy room for the best results. See our recent Activity Feature series for ideas on how to do just that!
- Why do some providers not accept my insurance?
In order to bill an insurance company, the business entity must be contracted with that insurance. Additionally, the individual therapist providing services must be credentialed with the insurance company. If the business does not have an existing contract with your insurance company, or the therapist has not completed the credentialing process with that particular insurance company, they cannot accept that insurance.
This does not mean the therapist is not licensed to provide services – becoming credentialed to provide services and being credentialed through an insurance company are separate processes. All speech-language pathologists are required to maintain an active state license in order to practice. You can check a therapists’ license status online through Provider Credential Search.