Speech therapy: does your insurance cover this?

[Anonymous]

DS has a fairly typical, confirmed articulation disorder (and is otherwise typically developing). Our insurance, Aetna PPO, has written a veritable treatise that goes into great detail on how it will NOT cover any sort of speech therapy whatsoever, unless the patient has been in an accident, had a stroke or was born with a severe disfigurement.

It's kind of harsh.

This got me thinking, did we just have the dumb luck to stumble into a plan that's really stingy? Do other common insurance plans cover speech therapy for the more common reasons?

[Anonymous]

We had the same problem as you and we have One Net PPO. I was very disappointed. Thankfully he only needed speech for about 9 months but it sucked to have to pay out of pocket.

[Anonymous]

You should be able to get those services from your school district. he Our middle son had a speech problem and the school district (Fairfax County) started him on early intervention at 3. He's 9 now and no speech issues except getting him to breathe between sentences!

[Anonymous]

I have Optimum Choice and my son was covered for 60 visits to an in network provider. I only had to pay a $10 copay per visit. I didn't have any trouble finding a good in network provider.

[Anonymous]

Blue Cross Blue Shield PPO covers it.

We went through the county process, but DD wasn't eligible for free services because the testing indicated she did not have the level of delay required...

[Anonymous]

Kaiser Permanente does not cover it.

[Anonymous]

Our Aetna - United Healthcare PPO covers it - unlimited.

Please bear in mind that it's not the insurer, it's the policy that determines the coverage. The insurer will provide whatever your employer has written into your group's policy. If your policy covers it, then your insurer is obligated to provide it.

[Anonymous]

Talk to your (or your spouse's) employer's HR Dept. That's who determines what kind of coverage is written into the policy.

[Anonymous]

We have Carefirst Blue Cross Blue Shield and it covers the in-network providers with a $15 co-pay. The problem is, all of the in-network providers are booked solid (I made an appointment for the initial evaluation a month ago, it was for the end of December and I was told that I was lucky to get in this early, they had had a cancellation). There is some coverage for out-of-network. DD is a little delayed in her speech, but not enough to get the free service through the government.

[Anonymous]

When we had Anthem of VA we got four visits a YEAR. As if my hard of hearing child could learn to talk in 4 visits!!

Now we have Blue Cross Blue Shield of Massachusetts. (My husband's company's HQ is based there.) They cover an unlimited number of sessions per year. The only restriction I've found is you can't have two in one day. But if I want to go once a day, every day, it's covered!

Complain, complain, complain at work. Ocassionally you will find someone who will listen.

[Anonymous]

Does anyone have information about insurance co. in California? My son is almost 3 and we want to get started this summer.

[Anonymous]

I had the same problems w/ OT for my son. Not covered at all unless it is rehab due to an accident or a congenital defect. I just had to suck it up and go into debt to pay for it myself. He didn't qualify through the county b/c they don't deal w/ sensory issues. Try a county evaluation first though.

[Anonymous]

We have Carefirst BC/BS and it's covered. Note that my daughter also receives school district services. However, we don't consider these sufficient.