Does my Insurance Cover Speech Therapy?

By: Eric DeGrove, Director , Sprout Therapy Services,

Understandably, this is one of the top questions we get at Sprout Therapy Services. Everyone knows medical and health insurance costs in the U.S. take up a big chunk of most families' budget. We all need to get as much out of our health insurance, Medicaid or other health program as we can. But, finding out if something is covered is often challenging.

The Challenge

Remember the last time you signed up for a new cell phone plan? Overage charges for minutes or data can be confusing, but all-in-all it's pretty straight forward. You pay X dollars per month and you get an particular amount of talk, text and web. With health insurance, you also pay monthly, but often you have little explanation of what medical services are covered. Often, the employee at the cell phone store provides more information about your cell phone plan than you receive about your health insurance.

If your health insurance is through you or your spouse's employer, they might have given you a brochure or booklet with medical conditions and services that are covered, and amount (deductible, copay) you must pay before they start chipping in. If you've shopped health plans online, either through Connect for Health Colorado (Obama Care), or on an insurance company's site, you've seen the same simplified information.

Under the break-down of benefits for plans it might say something like, "20 visits for Speech Therapy." The problem: There are often conditions under which your plan will actually approve and pay for 20 visits of speech therapy. These conditions, or maybe exclusions under which they will not pay, are rarely printed on health plan brochures or websites. You must call your health insurance company to verify if they will cover speech therapy for your child.

Use This Worksheet to Find Out if Speech is Covered

At Sprout, we are here to help our patients and families, not only through excellent therapy, but the entire process of figuring out how to pay for it. Because insurance is a big and complex part of the process, we created this step-by-step worksheet to help you know exactly what to ask when you call.

Download the PDF file below and you can either fill it out on your computer, or print and complete by hand. Either way, make sure you fill it out during the call and keep a copy for your records. And of course, if you have any questions and you are in Colorado Springs, please give us a call at 719-999-8417. We are here to help.