Many people are unaware that speech pathology services are covered by their current health insurance plans. If you or someone in your family requires speech-language therapy, check with your insurance provider to determine if you are covered and how much funding you could receive.
We will outline some of the cases in which speech therapy may be necessary and some of the ways to check if your health insurance offers coverage.
What Is Speech-Language Therapy
Speech-Language Therapy is the evaluation and treatment of a wide variety of communicative disorders in children and adults. Speech therapy is performed by certified speech-language pathologists registered with the College of Audiologists and Speech-Language Pathologists of Ontario (CASLPO).
Speech therapy aims to address speech and language challenges such as articulation delays, cognitive-communication disorders, autism spectrum disorders, accent modification, social language delays, and much more.
Children with signs of communication difficulties can benefit from early treatment to help reduce the impact of delays as they grow. Adults, in many cases, require speech therapy services due to an illness or an injury. However, many people benefit from the help of speech pathologists in simply modifying their communication abilities.
Common Speech Therapy Challenges
Language Delay: Language delays are characterized by a child not understanding or using language skills following the typically expected timeline. For example, by the age of four, children can generally participate in a simple conversation with adults.
Articulation, Motor Speech, and Phonological Delays: When children cannot use or understand words properly, a speech pathologist will help to determine the nature of the child’s speech challenges, any specific sounds that a child is experiencing trouble with, and guiding them in improving the clarity of their speech.
Stuttering: A person who stutters will have challenges speaking fluently. There may be a wide variety of reasons for this. A certified speech-language pathologist will provide an assessment and a treatment plan to implement strategies to help the individual speak more fluently.
Aphasia: Aphasia is generally related to an injury or an illness such as a stroke, dementia, or other brain trauma. Aphasia impacts a person's ability to speak, understand, and find the correct words in everyday life. Setting goals and exercises can help individuals with aphasia to improve their communication skills.
Accent Modification: A person's accent is a beautiful thing and allows us to enjoy the sounds of different cultures. However, suppose a heavy accent causes communication challenges, leading to frustration for the speaker in the workplace or everyday life. In that case, a speech-language pathologist can help to pinpoint areas where an accent can be modified for easier communication.
Cognitive-Communication Challenges: A person who has experienced a brain injury may suffer from cognitive-communication challenges. These individuals may struggle with planning, executing, and participating in daily activities and can benefit greatly from a speech-language pathologist’s support. Together, they can develop ways to compensate for their challenges and offer solutions that allow a person to participate more openly in daily life.
Types of Coverage
There are two main types of coverage that you may be eligible for. These include private insurance benefits and government-funded programs. Private insurance providers are third party providers to whom you pay a monthly fee in return for coverage of extended healthcare services when you need them.
Government programs are designed for specific purposes to help support individuals with various challenges. Some examples of government-funded programs include the Child Disability Benefit, Special Services at Home, the Ontario Disability Support Program, and Assistance to Children With Severe Disabilities.
How Can You Find Out If Your Insurance Covers Speech Therapy?
Each insurance provider's coverage is different. The best way to determine if speech-language pathology services are covered is to check with your provider. This is often available in a copy of your benefits plan or online on your provider's website.
If you are unsure of where to look, or if the wording within the coverage package is challenging to understand, you can call your insurance provider directly to ask about speech pathology services specifically.
How Much Coverage Can I Receive?
This will depend on your insurance provider. Plans vary and it is best to consult your benefits package to find out exactly how much you could receive.
Whether it is a portion of the total cost or complete coverage, having the help of your insurance provider can make a big difference in the overall expenses involved with speech therapy. It is especially important to check your coverage if it means the difference between your ability to access treatment or not.
Applying For Coverage
If you do not currently receive insurance coverage from an insurance provider, you can apply easily through most companies’ online portal. Insurance providers generally offer a free quote to allow potential clients to get an idea of how much the monthly or annual payment will cost.
It is important to get quotes from different providers to allow you to compare prices and the level of coverage that you may receive for speech therapy.
Most providers (manulife, sunlife, green shield, etc) include coverage for speech therapy in their plans. Here is a helpful link to compare rates and coverage: https://healthquotes.ca/
Policy Language
The language used to describe coverage in an insurance policy is sometimes difficult to understand. Read through your insurance policy carefully. If you have any remaining doubts, give your provider a call and ask them to explain the policy and ask specifically about the type of therapy you need.
Resources
Here is the main resource for finding funding for your online speech therapy services.
https://www.osla.on.ca/page/ServiceinOntario
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