Obtaining insurance coverage for stuttering treatment can be a challenge for many reasons. First, insurance reimbursement for speech and language services, in general, may not be included in your benefits plan. Furthermore, many plans have specific exclusions for stuttering that result from a lack of knowledge about the disorder. In fact, many NSA members report that their claims are denied or that their policy does not cover stuttering.
The NSA has established an Insurance Advocacy Committee, which is a group of Speech-Language Pathologists dedicated to helping people who stutter (and parents of children who stutter) obtain better insurance coverage for treatment. Committee members have extensive experience in clinical and research activities related to stuttering. Members represent a variety of treatment settings, including hospitals, clinics, schools, and university programs.
The NSA Insurance Advocacy Committee has developed a comprehensive Insurance Advocacy and Stuttering brochure to guide you through the process of obtaining insurance coverage.
In association with The Stuttering Center of Western Pennsylvania and a partnership of Children's Hospital of Pittsburgh and the University of Pittsburgh we have also developed a number of sample appeal letters (in Microsoft Word format) that can be used to appeal denied claims. Click on sample appeal letters to see these sample letters.
Advocating for appropriate insurance coverage for people who stutter can be done on many levels. We encourage you to take steps to help advocate for insurance coverage by doing the following:
- Appeal denied claims for stuttering treatment on all levels. Claims may be appealed with the insurance company.
- Contact your employer to determine if speech therapy is part of the covered services in your plan. If it is not, encourage your employer to include it in the plan by educating them on speech and language disorders.
- Contact your state insurance commission or legislators if you feel that services should be covered and you have failed on your appeal attempts.
- Take steps to educate the public about stuttering. Public awareness can help advocacy efforts.
Remember that insurance plans may vary significantly on the amount of coverage they provide for speech therapy services. You should determine your exact speech therapy benefit before beginning treatment services so that you know your coverage.
We are committed to helping consumers and professionals work together to advocate for improved services and more comprehensive insurance coverage for people who stutter. In fact, the NSA is compiling a list of effective strategies. Please send your own ideas and copies of successful appeal letters to Craig Coleman at craig.coleman@chp.edu. You will be contacted about how your ideas can be used to help others. Together, we can make a difference! |
