Is Speech Therapy Covered by Insurance? How to Use Your Insurance for Speech Therapy
June 6, 2023
Does insurance cover speech therapy? Yes, but it’s complicated…
Yes, many insurance plans cover speech therapy, but it depends on the specific plan and the policies of the insurance company. Speech therapy is often considered a form of rehabilitative therapy and may be covered under medical insurance plans. However, the extent of coverage can vary widely. Some plans may cover only a limited number of visits, while others may cover a greater number of visits or a broader range of speech therapy services.
It's important to check with your specific insurance plan to find speech therapy covered by insurance and identify what the terms of the coverage are. You can also check with the speech therapist's office to see if they accept your insurance plan and what the out-of-pocket costs may be.
Is out-of-network speech therapy covered by insurance?
Some insurance plans may provide some level of coverage for out-of-network speech therapy, but the benefits may be less than if you were seeing an in-network provider. Other plans may not cover out-of-network speech therapy at all, in which case you would be responsible for the full cost of the services.
It's important to check with your insurance provider beforehand to understand the terms of your coverage if you are considering seeing an out-of-network speech therapist. You can also check with the speech therapist's office to see if they accept your insurance plan and what the out-of-pocket costs may be.
Keep in mind that if you do see an out-of-network provider, you may be responsible for paying a higher copayment or deductible, and you may need to meet a higher out-of-pocket maximum before your insurance coverage kicks in.
Do speech therapists take insurance even when they are not part of any network?
Yes, speech therapists who are not part of any insurance network may still accept insurance. These speech therapists are often referred to as out-of-network providers, and they may bill your insurance company directly or provide you with a receipt or claim form that you can submit to your insurance company for reimbursement.
However, if the speech therapist is not part of your insurance network, you may be responsible for a higher out-of-pocket cost than if you were seeing an in-network provider. This is because your insurance plan may not cover as much of the cost of services provided by out-of-network providers.
If you are considering seeing an out-of-network speech therapist and are unsure about the cost or coverage, it's important to check with your insurance company beforehand to understand the terms of your policy. You can also check with the speech therapist's office to see if they accept your insurance plan and if they are willing to bill your insurance provider directly for services, or if you will need to submit a claim for reimbursement.
Does health insurance cover speech therapy differently depending on your plan?
Yes, health insurance coverage for speech therapy can vary depending on the specific insurance plan you have. The details of speech therapy coverage, including the number of visits covered, any copayments or deductibles that apply, and the types of services that are covered, can all vary depending on your insurance plan. Some plans may require pre-authorization or a referral from your primary care physician before you can receive speech therapy.
Some insurance plans may offer more generous coverage for speech therapy, while others may offer more limited coverage or no coverage at all. It's important to check with your insurance company to understand the specific terms of your speech therapy coverage. This can help you determine what services are covered, how much you will be responsible for paying out of pocket, and whether you need to take any additional steps to ensure that your care is covered by your insurance plan.
Read our explainer post for more help choosing a health insurance plan.
How to find speech therapy covered by insurance
If you are looking for speech therapy covered by your insurance, there are several ways to find it:
- Check your insurance provider's website: Most insurance providers have a website where you can search for in-network speech therapy providers in your area. You can typically search by location, specialty, and other criteria to find a speech therapist who is covered by your insurance plan.
- Call your insurance provider: If you prefer to speak to a representative, you can call your insurance provider's customer service number and ask for a list of in-network speech therapy providers in your area. The representative can provide you with information on the speech therapists in your area who are covered by your insurance plan.
- Ask for recommendations: You can ask your primary care physician or other healthcare providers for recommendations for speech therapy providers who are covered by your insurance. You can also ask friends or family members who have received speech therapy for their recommendations.
- Contact speech therapy providers directly: You can contact speech therapy providers in your area and ask if they accept your insurance plan. They can also provide information on the out-of-pocket costs you may be responsible for, and any other information you may need to know about receiving speech therapy with your insurance plan.
By using these methods, you can find speech therapy covered by insurance and determine who can provide the care you need.
What to do if you can’t afford speech therapy
If you are unable to afford speech therapy, there are several options you can consider:
- Look for free or low-cost clinics: There may be free or low-cost speech therapy clinics in your area that offer speech therapy services. You can search online or contact your local health department or community health center for more information.
- Consider alternative treatments: If you are unable to afford speech therapy, you may want to consider alternative treatments, such as online therapy, telepractice, or self-help materials, which can help to improve your speech or communication skills.
- Look for speech therapy schools: Speech therapy schools may offer low-cost or free speech therapy services as part of their training programs. Contact the schools in your area to see if they offer such programs.
- Talk to your speech therapist: If you already have a speech therapist, talk to them about your financial situation. They may be able to work with you to create a payment plan or provide services at a reduced cost.
- Consider support groups: Support groups for individuals with speech or communication difficulties can provide emotional support and helpful tips for managing your condition.
Remember that it's important to prioritize your health and seek care when you need it. Don't hesitate to reach out to healthcare providers or organizations for help and support.
How SuperBill helps with speech therapy insurance
If you do have OON benefits, or you’re unsure if your insurance covers speech therapy, SuperBill may be able to help! SuperBill verifies your benefits, then files and tracks your out-of-network claims. We will update you on the status of your claim at every interval, and do everything we can to get it reimbursed. We even help with medical bill negotiation!
You can jump through all the hoops to make sure you get your speech therapy covered by insurance, OR you can let SuperBill for insurance handle it all for you. We have worked with countless patients to get them the reimbursement they deserve.