If my plan says I am covered for speech therapy, why is there a cost?
Having speech therapy coverage simply means that you are eligible to receive speech therapy services. But in most cases, your coverage includes some financial responsibility. Typically with speech therapy, you will be responsible for a copayment, coinsurance, and/or deductible for each visit. These costs are determined by your health insurance company and depend on the plan you and/or your employer have chosen.
What's a copay?
A copay, or copayment, is a fixed dollar amount predetermined by your health insurance that is due at each appointment.
Coinsurance is a fixed percentage of the allowed amount for each appointment which you are responsible to pay. For example, if your health insurance plan has an “80-20% coinsurance”, your health insurance will pay 80% of the allowed amount of the cost of the visit, while you are responsible to pay the remaining 20%.
What's a deductible?
A deductible is the total amount you are responsible to pay before your health insurance will make payments toward any healthcare expense (not just treatment at Back Bay Speech Therapy). For example, if you have to meet a $1,000 deductible, you are responsible to pay the entire allowed amount for each appointment until you have spent $1,000 on services subject to a deductible (some health services are covered without having to meet your deductible, but that is individual to each health insurance plan). In other words, you are paying the amount your health insurance company would pay if you didn’t have a deductible. Once your deductible is met, your financial responsibility will change. You will either be responsible for a copay, a coinsurance, or your health insurance could cover all of your future health care expenses.
What if my plan is not listed?
We offer private payment plans for evaluations and therapy. You may also seek "out of network" coverage with your insurance company directly, to see if reimbursement through your plan is available.
For additional information about insurance plan options you can visit the American-Speech-Language-Hearing Association (ASHA).
If you have concerns regarding your child's speech or language development, contact Back Bay Speech Therapy to schedule an evaluation.