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Understand health insurance coverage for speech therapy; appeal insurance denials, court decisions, tips for gaining coverage, etc.

  • Insurance and Speech Therapy Funding Resources

    Making Sense of Your Health Insurance Plan – from the American Speech Language Hearing Association Getting Health Plans to Pay for Pediatric Verbal Apraxia Consumer Checklist for Getting Improved Speech-Language Service Coverage In Your Insurance Policy For less than $1.00 per month you can add coverage to your health plan that will help you or […]

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  • What I Learned Fighting My Insurance Company… or Keys to Successfully Acquiring Speech Therapy Services through a Managed Care Organization.

    By
    Lea Nolan, M.A.

    Last spring we learned that our son, Riley was diagnosed with severe Childhood Apraxia of Speech (CAS). Our excellent Early Intervention speech language pathologist (SLP) provided the first diagnosis and helped structure our Individualized Education Program (IEP). She strongly suggested that we supplement Riley’s weekly school-based speech services with several private speech sessions. I learned […]

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  • Applying for Social Security Disability Benefits for a Child with Apraxia

    If your child has apraxia of speech – either as a primary condition or associated with another condition – then he or she may be eligible to receive disability benefits through the Social Security Administration’s (SSA’s) Supplemental Security Income (SSI) program and/or Social Security Disability Insurance (SSDI) program. Apraxia may significantly impact your son or daughter’s ability to […]

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  • How State Insurance Commissions Can Help With Insurance Funding

    Apraxia-KIDS works with parents to assist them in understanding how to file insurance appeals regarding speech therapy. One tip that is perhaps underutilized is having consumers request the assistance of their State Insurance Commission in resolving issues. Filing a complaint can actually be accomplished with some ease because most states have online submission for complaints. […]

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  • Apraxia – Insurance Coverage Tips for Parents

    (Adapted with permission from the Children’s Hospital of Cincinnati) If your child has been referred or you are pursuing a speech-language evaluation or treatment, the following may be helpful in understanding the process of accessing your health care benefit program: To request authorization for coverage: Call your child’s doctor: Contact the doctor who is referring […]

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  • Sample letter to Employer’s Human Resource Director/Union Representative

    (Reprinted with permission from Childrens Hospital of Cincinnatti and the Ohio Speech Language Hearing Association) Dear (Employer’s Human Resource Director/Union Representative), This letter is in regards to our current inadequate health benefit coverage for pediatric speech, language and hearing services. I recently tried to obtain insurance authorization for speech-language pathology services for my child and […]

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  • Sample Human Resource Letter Regarding Maximum Visit Policy

    (Reprinted with permission from Childrens Hospital of Cincinnati and the Ohio Speech Language Hearing Association) Dear (Employer’s Human Resources Director/Union Representative), This letter is in regards to our current inadequate health benefit coverage for pediatric speech, language and hearing services. This year, our plan only provides coverage for a maximum of 20 speech therapy benefits. […]

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  • Model Insurance Plan Benefit for Pediatric Speech, Language and Hearing Services

    (reprinted with permission from Childrens Hospital of Cinncinnatti and the Ohio Speech Language Hearing Association) The following speech, language, and audiology procedures are covered when rendered by a speech-language pathologist or audiologist who is certified by the American Speech-Language-Hearing Association and, where appropriate, is licensed by the state. Speech-language assessment and audiological assessment Provision of […]

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  • Insurance, Been There…Done That…

    By
    Kathy Hennessy

    One day, in a fairly irrational moment, I sat down and figured out what the total cost of speech therapy would be without insurance. I guess as the mother of two children with apraxia, I have developed a dark sense of humor about all of this. Where did I get my numbers? Honestly, I just […]

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  • Insurance Commission Ruling from Michigan

    (reprinted with permission from the Office of Financial and Insurance Services, Department of Consumer & Industry Services, State of Michigan) January 31, 2003 File No. 51428-001 Petitioner: Respondent: XXXXXXXXXXXXX Blue Cross Blue Shield of Michigan Issued and entered January 31, 2003 by Frank M. Fitzgerald, Commissioner ORDER I: PROCEDURAL BACKGROUND On December 18, 2003, XXXXXXXX […]

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