Does Insurance Cover Speech Therapy?

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Parents of children with speech delay often ask, “Does insurance cover speech therapy?”

The answer, however, is not a simple one. Not only are there different insurance plans, but there are also multiple reasons for speech delay.

Speech therapy is covered for some diagnoses but not for all. Plus, you need to submit forms and wait for your claim to process.

While it seems like a long and tedious process, it will result in substantial cost cuts for your family.

Indeed, insurance coverage is a complicated topic, so you will need to pay attention as we unwrap these complexities for you.

The Kind of Insurance Coverage You Have

Insurance companies offer different benefits with each policy. Reimbursement policies are also different in each case.

Some insurance companies require pre-approval, while others don’t have such conditions.

In some cases, such as HMO plans, a physician’s referral is necessary. Other plans, such as PPO, do not require that.

Similarly, plans also differ in terms of benefits and limitations. Some companies have limited options, while others offer unlimited benefits.

That’s why it is a complex process and does not have one-line answers to your questions.

There are, however, some crucial points that will help you navigate this process smoothly, so stick along for more.

Does Insurance Cover Speech Therapy?

In most cases, insurance will cover speech therapy if your child suffers from an acute illness or injury.

Acute illness is a short-time illness with clear symptoms and requires short-term care. It comes and goes rapidly, unlike a chronic illness that lasts long.

Also, your insurance will cover speech therapy when it’s adjunct to a major illness, such as a stroke or TBI.

While it’s good news for many parents, children with chronic illnesses or developmental challenges generally do not get insurance coverage.

Sadly, the same is true for those whose speech problem is not associated with an injury or a condition.

The majority of insurance companies do not offer coverage for developmental speech disorders, such as speech delay and articulation disorders.

Some may offer partial coverage for such challenges. However, the benefits will be limited even if a company offers coverage for chronic problems.

In some cases, insurance plans deny coverage for disorders in school-aged children because schools offer therapies for such issues.

The problem is that not all children can get therapy at school, especially when their disorder is not considered “educationally handicapping.”

does insurance cover speech therapy

Options Other Than Insurance Coverage

Even when your insurance does not fully cover speech therapy, you might have some hidden benefits that may help you save some money.

Here are some tips to get these benefits:

Initial Assessment

Your insurance might not cover the ongoing therapy sessions, but it may cover the initial assessment.

A qualified speech therapist may evaluate your child to diagnose them for a disorder and recommend a treatment plan.

To get benefits, you can then apply to the insurance company for coverage and get approval.

Depending on your package, your insurance company may allow you to partially benefit from your plan.

Early Intervention Program (EIP)

If your child is three years old or younger and has a speech disability, you can avail of the early intervention program from your state.

Every state has an early intervention program under federal law, which allows parents to get free therapy for their young children.

Some states even allow the program to continue until the age of five.

The program does not need professional evaluation or recommendation. Parents, teachers, health care providers, and social workers can refer a child for EIP.

You only have to contact your local EIP representative and ask for an evaluation. The contact numbers for each state are available on the ECTA website.

Helpful Resources for Children With Speech Challenges

Your insurance may or may not cover your child’s speech therapy. Still, you can play a part in speeding up your child’s recovery.

Doing so will not only be immensely helpful for your child, but it will also save you a good amount of money.

To help your kid develop social and communication skills, you can use educational toys that are engaging and interesting.

These toys are specially designed to impart maximum skills while being entertaining at the same time.

Let’s look at some of the best toys for children with speech challenges:

1. Your Baby Can Learn! Deluxe Kit

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When your child struggles to speak, they need a complete guide that includes visual and verbal techniques for them to learn. For that, this award-winning kit can help.

The Your Baby Can Learn! Deluxe Kit provides all those aids to your child.

It includes videos featuring kids, which is much more effective. These videos teach your child to speak through the repetition of simple vocabulary.

It has five volumes that increase in complexity.

The first volume introduces simple words such as mouth, nose, and arms. These words are presented to children through gestures.

The kit also contains flashcards, sliding word cards, a digital book, parent instructions, and five lift-the-flap books.

It is designed for ages three months to five years. You can get DVDs, but the digital option is better as you can stream and download them on your smartphone or tablet.

2. Yoto Player – Kids Audio Player & 7 Cards Starter Pack

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Kids love portable toys with beautiful designs, and the Yoto Player is one such educational toy that can help them learn while playing.

It is free of screen, microphone, and disruptive ads. It’s an audio player where children can insert a card of their choice that plays stories.

Kids can easily control it with large buttons and can take them anywhere they want.

It is sort of a cassette player, but it has many more options. It has an audio jack, a clock, Bluetooth connectivity, and a magnetic charger. It also has a night light.

There are multiple stories suitable for ages three to 12 years old. You can also play your child’s favorite songs, and it also contains audio for meditation.

The two buttons on the top are for changing channels and adjusting the volume.

It can play a podcast and a family-friendly radio all day long just by pressing the buttons. You can also create your own cards for your favorite songs, audio, and stories.

3. AMOSTING Pretend & Play Ride-On Toys for Toddlers

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When your child feels bored, you can use pretend and play toys to keep their interest in the game while learning. One such wonderful toy is the AMOSTING ride.

It contains all the features of real-world driving, including a race pedal, brake, turn signals, steering wheel, and horn.

The steering wheel turns the car in the screen towards the right and left, thus creating an association between the two.

The toy has three buttons that introduce your child to a fire truck, an ambulance, and a police car.

There are different colored lights and songs to keep your child’s attention in the driving game.

The AMOSTING Pretend and Play Ride-On Toy does not require any assembly. Just put the AAA batteries in and turn the power button on for your child to enjoy.

The toy is perfect for kids above 18 months. By exposing your child to different sounds, his brain will have a better chance of developing communication skills.

Playing with him also helps improve how he socializes.

Getting Your Child the Best Care Possible

As you can see, the question, “Does insurance cover speech therapy?” is a complex one.

You will need to be as thorough as possible to get the benefits your insurance company can offer.

If you are vigilant, you can check the signs of speech delay at an early age and benefit from your state’s early intervention program.

In any case, you will need to provide maximum support to your child to help them acquire the necessary communication skills.

Books on children’s speech challenges can help greatly, allowing you to learn about your child’s problem and how to handle it.