What to Do When Insurance Won’t Cover Your Speech Therapy Costs
Feb 8, 2022 Your speech therapist told you to wait with therapy to get approval form insurance to continue working with your child. As many families you are financially limited. What to do now? What if your insurance doesn’t pay for services?
Unfortunately, our insurance companies run the show when it comes to reimbursement for speech and language services. They dictate what is and isn’t covered, which can be extremely frustrating when your child needs speech therapy. I’ve had many clients who needed the services desperately, couldn’t afford to pay out of pocket, but insurance kept denying claims. Here is some advice for when the insurance companies refuse to pay or continue services.
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What are Your Other Options?
The first thing I’d suggest is early intervention. This is typically a free, or low-cost program that states have for children who are 0-3 years-of-age.
Once contacted, they come to your home to determine if services are warranted and how often they are needed. The cost is based on your income. I’ve been an early intervention therapist for many years and most of my families pay nothing for services.
The catch? Not all children qualify for these services. I’ve also, unfortunately, had parents whose children definitely had a speech delay, but weren’t severe enough to qualify on standardized assessments. When this happens, the parents have no choice but to receive outside, private therapy OR wait until the child enters school – something I never suggest.
Private Speech Therapy
I know private therapy can be expensive – especially if you aren’t going through insurance. As a private therapist, I work with families who cannot always afford the amount that is charged for an evaluation and subsequent therapy. I don’t offer my services for free, but I try to work with them to work out a payment plan in order to get their child the services they need.
I wish I could tell you that all private speech therapists do this, but they do not. If you’re looking into private services, make sure you ask the therapist/owner if they do accept payment plans. You might be surprised with their answer.
If you cannot find a private speech therapist that does payment plans, you may need to budget for 1-2 times a month. $50 a month, might be more doable than $200 and it’s worth your child getting speech and language therapy, if they really need it.
Speech Therapy at Colleges and Universities
Many colleges and universities that offer speech pathology as a major, have a student clinic. The therapists are college seniors or graduate students who are under the instruction of Master’s level (or higher) therapists who have been practicing for many years. These students receive weekly feedback regarding their therapy sessions and are advised as to how to proceed by their instructors.
Most of the time, these clinics have a much lower charge than a typical private practice because it is students that are providing the therapy. They take all types of clients in order for the students to gain experience. Caution – waitlists can be long due to the fact that the cost is lower.
School System and Speech Therapy
If your child is in the school system, there should be free speech therapy that can be provided, if they qualify. These services will not cost you anything.
In order to receive therapy, they need to be evaluated by the teams SLP and a formal Individualized Education Plan will be formed to include therapy. The SLP will meet with your child either 1-2 times per week, depending on their diagnosis. Therapy can be provided individually or in a group setting. In addition, the therapist may see your child in their class OR in the speech therapy room.
As a school-based speech-language pathologist (SLP), I see the majority of my students in the classroom! It allows me to see first hand what they are struggling with in regards to their curriculum. Then, when I see them in my office, I know what skills to target!
If All Else Fails . . .
I wish I could tell you that this problem with health insurance is going away, but it isn’t. It’s a daily fight for clinicians to receive authorization for therapy to be provided to their clients. On top of that, many companies are so inundated with referrals that they simply don’t get to them in a timely manner.
If all else fails, there are things you can do at home to help your child be more successful with speech and language. This does not replace speech therapy services, BUT it can help until you can get into a therapist’s office.
Speech Blubs has free online resources that you can check out in order to facilitate communication in your home. If you download the Speech Blubs app, there are a ton of resources, games, activities and suggestions for you to utilize.