While insurance definitely helps reduce the cost of speech therapy, private pay certainly has its benefits as well. Let’s break down the pros and cons of using insurance vs. private pay.
Insurance Pros:
Saves you money if your insurance covers speech therapy
Insurance Cons:
Dictates how much of the cost is covered
Decides how long or how many sessions are covered- Example: the recommended service is 2x/week for 6 months to a year, but your insurance only covers 20 sessions a year
Which providers are in-network- the provider you want to work with may not be in-network or the providers who are in-network could be a far commute or they have extremely long waitlists
Determines what is covered. They may deny services if they don’t agree that there is “medical necessity” for speech therapy or if your child does not meet their requirements to qualify for covered services. Example, your child’s targets are phonological processing skills or articulation that do not fit their definition of medical necessity or you child doesn’t score low enough on a standardized test to meet their requirements
Private Pay Pros:
Since you cover the cost, freedom and flexibility of services is the biggest pro. Your treatment plan is between you and your SLP. You have significantly more control over who your provider is, what services you receive, the duration and frequency of those services, and how fast you can start receiving services.
You can target a variety of areas that wouldn’t be covered by insurance- Example: your child is receiving services or articulation for a sound they can’t pronounce or language and phonological skills to increase their academic success.
Saves you time- you don’t have to wait weeks for your insurance to approve and begin services, appeal denials, or make frequent calls to get answers about bills or coverage
You can use an HSA or FSA to offset the cost if you have one
Private Pay Cons:
You pay for the entire cost yourself
The cost of speech therapy definitely takes planning and consideration, but the time and deliberation will be well worth it. You are helping your child become a confident communicator! There’s never a better time to start speech therapy than right now!
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