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    Education Station  Speech Therapy  Insurance

    Though families generally do not think of speech therapy when purchasing health insurance, talking is a necessary life function and, when disrupted, is life affecting. Many health insurance plans cover speech therapy. There are often limitations to the amount of coverage a member will receive, but in many cases the coverage is enough to provide for the needs of your child.

    If you have concerns about your child's language development, the first step is to take your child to see the pediatrician. Explain your concerns to the doctor. She will often provide you with a "referral" to have your child evaluated by a speech-language therapist. The "referral" is a part of the paperwork process often required by the insurance company. Your doctor might be familiar with your insurance company and its typical requirements. If she is not aware of your health insurance benefits, call the member services department at your insurance company to have them relay to you what steps you need to take to receive a speech-language evaluation. It is also a good idea to check your insurance benefits booklet for yourself so that you're aware of the coverage. Not all insurance plans at the same insurance company provide for the same coverage.

    Typically an insurance company will not deny the referral to the initial evaluation. After the evaluation, the speech therapist will tell you the diagnosis or give you a "working diagnosis". She will also relay the diagnosis to the insurance company and make recommendations for treatment, if needed.

    It is often at the point at which the speech therapist submits to insurance for pre-approval of the recommended speech therapy that families receive the first denial (by insurance) of the claim.

    If you receive a denial, read through the following information to guide you in your appeal.

    Which of the following best describes your child's diagnosis and / or need for insurance converage?

    Aphasia

    Apraxia of Speech

    Articulation Disorder

    Augmentative Communication Device

    Dysarthria

    Pervasive Developmental Disorder

    Phonological Disorder

    Semantic Pragmatic Language Disorder

    Specific Language Impairment

    Speech Delay (Late Talker)

    Stuttering (Dysfluency)

    Additional Information

    Resources for Professionals:

    Audio and videos: Insurance Coverage
    Consumer Action: Choosing and Using a Health Plan


     Language Conferences, Seminars, and Workshops
     Help for Late Talking and Language Delay



     

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    Speechville Express is a resource for families, educators, and medical professionals, offering information about language development in children, helping those who care for toddlers and young children who are late talkers, and connecting you with others who have been down this road. Language disorders and communication impairments included are apraxia, stuttering, pervasive developmental disorder, dysarthria, and aphasia, among others.

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    Last updated: Wednesday, Jul 1st 2009
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