Is Speech Therapy Usually Covered by Insurance?
June 9, 2022 by Kelsey Wagner
Speech therapy is an important tool for treating speech disorders and impairments, but is speech therapy covered by insurance? Read on to find out.
More than 7 million Americans have a voice disorder that affects the pitch, sound or quality of their voice. Thankfully, speech therapy can help. Yet, if you’re considering visiting a speech therapist, you may feel overwhelmed with the costs and dealing with insurance issues.
Is speech therapy usually covered by insurance? Keep reading to learn more.
What Is Speech Therapy?
Speech therapy treats problems with communication or in producing the sounds needed for spoken language. Speech-language pathologists (SLPs), or speech therapists, assess and treat these conditions. Both children and adults with speech disorders and impairments can benefit from speech therapy.
Let’s take a look at some of these disorders.
An articulation disorder is when someone cannot form certain word sounds correctly. A person with an articulation disorder may drop, swap or distort sounds. They may also add extra word sounds. For example, a person may say “wed” instead of red, or “diss” and “dat” when they mean this and that.
Stuttering or stammering is a fluency disorder. A fluency disorder affects the speech in terms of:
This disorder makes it difficult to get out a sound. It can also cause repetition and blocked or interrupted speech.
Cluttering is another fluency disorder. Cluttering causes speech that is rapid or irregular, unclear and disorganized.
A block or obstruction to regular air flow creates a resonance disorder. The blockage can be in the nasal or oral cavities. It can also occur if the velopharyngeal valve (the soft palate, pharynx and side and back walls of the throat) doesn’t close properly.
The disorder alters the vibrations that determine voice quality. For example, a cleft palate, neurological disorder, or swollen tonsils can cause a resonance disorder.
A person with an expressive language disorder has difficulty in expressing their ideas or conveying information. Developmental impairments and head trauma can cause expressive disorders.
Biological problems can cause memory, speaking and listening issues. Brain injury, damage and trauma can also lead to a cognitive-communication disorder.
Aphasia is an acquired disorder that affects the ability to speak and understand others. It can also make reading and writing difficult. The most common cause of aphasia is stroke on the left side of the brain, but it can also result from brain injury and infections and progressive neurological disorders like Alzheimer’s disease.
There is more than one type of Aphasia, and this language disorder is incredibly frustrating to those who experience it post-stroke. It is often misunderstood by other people, who assume the stroke survivor is simply, “having trouble finding their words, which happens to all of us”. It’s more than that – and it’s something that a speech pathologist can successfully treat in stroke survivors.
People with dysarthria have slow or slurred speech caused by weakness or inability to control muscles used to produce speech. Nervous system disorders often cause dysarthria.
The Importance of Speech Therapy for Stroke Survivors
Stroke can change everything instantaneously, from a person’s ability to move their body to controlling their emotions. Taking away a person’s ability to communicate with others can be a cruel byproduct of the damage to the brain that a stroke survivor encounters.
Helping stroke survivors regain their ability to effectively communicate their needs and feelings can be a big win for everyone involved. For this reason, a properly trained speech pathologist should be an active member of a stroke survivor’s recovery team.
Speech Therapy Cost
The cost of speech therapy is based on treatment time and not per diagnosis. A private clinic can range from $150 to $250 an hour. However, visiting a speech therapist connected to a hospital may cost more.
The fee doesn’t include the initial evaluation. The speech therapist will perform an initial assessment or speech evaluation before beginning therapy. The tests will help determine which treatment plan is best. The speech therapist can also identify skills and areas of challenge during the initial assessment.
A typical assessment is two sessions, each up to four hours long. It can cost around $300-$500.
The fees of speech therapy can change widely depending on factors such as:
- Where you live
- Type and frequency of treatment
- Where you will receive services
- If you plan to use insurance
- Your insurance coverage
Often, therapists don’t advertise how much they charge. You will likely need to contact each speech therapist you’re interested in seeing to get information on pricing.
Each therapy session should include:
- One-on-one (in-person or online) treatment with a trained speech-language pathologist
- A specialty treatment room (if in-person)
- Treatment materials and tools
- A treatment plan to ensure therapy success
The therapist should use different methods and tools based on your level of speech disability and the underlying cause. Many clinics also offer more direct assistance in educating you about your individual speech challenges and helping you learn to manage them in your day-to-day activities.
Alternative Treatment Options
Traditionally, speech therapy required an office visit or a therapist to travel to your home. But there is an alternative to office or home visits: telemedicine. Online speech therapy is becoming more prevalent and is a nice alternative to in-person therapy. This approach can offer convenient access to expertise that would otherwise be unavailable based on geography or other physical access factors.
A therapist using telemedicine services will connect and work with you via video call. However, the method may not be ideal for everyone. This is dependent on treatment needs, the amount of additional support needed, and access to adequate internet services.
If you are seeking speech therapy services for a child, you may want to explore school-based speech therapy. Some schools offer speech therapy options to help children improve their communication skills and is free of cost if your child qualifies.
Typically, in-home care is the most expensive option because there are travel expenses involved in addition to the therapist’s time. The cost for telemedicine is comparable to in-person care.
In all cases, low-income households can also apply for Medicaid benefits to help cover the costs of speech therapy.
Insurance Tips for Speech Therapy
Insurance coverage is more likely for patients with an acute illness or injury. For example, your health insurance usually covers speech therapy for a baby born with a cleft lip or a stroke that causes speech impairment.
Insurance coverage may be more limited for developmental or chronic disorders; some insurance policies won’t cover speech therapy—indefinitely or sometimes at all—for a long-term condition.
Of course, the cost of speech therapy is lower if you’re covered by health insurance rather than if you’re paying out of pocket. But each insurance plan has its own benefits, and every insurance company handles reimbursements differently. Thus, there is no one-size-fits all answer.
It’s essential to have your diagnosis and referral information available to assess your insurance coverage when beginning therapy. Contact your insurance company and see what your plan already covers. Consider in-network treatment versus out-of-network treatment. You are likely to save more money this way.
Is Speech Therapy Usually Covered by Insurance?
Here’s some good news if you already have health insurance: speech therapy is often covered. The ability to speak and communicate following a stroke or other brain injury is an important ability to regain for so many reasons.
The first step is getting a doctor’s diagnosis of a speech disorder and a referral for treatment. Then, contact your insurance company to see how to proceed.
We understand how important it is to regain your voice after experiencing a brain injury and will work with you to help you effectively communicate and recover.
If you’re still wondering, “Is speech therapy usually covered by insurance?” contact Kintinu Telerehab at (531) 210-5700. Our expert clinicians can discuss the insurance policies we accept and help you book an appointment today.