I hear this question almost as often as “how do I know my child needs speech therapy?” Insurance is a tricky topic and varies for each person depending on their specific plan and benefits. I completely understand families wishing to use those benefits. It’s true healthcare providers are in-network for good reasons. However, here are our top four reasons we choose not to accept insurance at this time.
Why don’t you take insurance?
1. Your needs come first.
Contracting with insurance companies could dictate the specific amount and type of therapy allowed. As a certified and licensed speech-language pathologist my ethical obligations are to you, the patient. I will always advocate for what’s best for you based on your needs, not what insurance mandates.
2. Only you can determine whether your treatment is working for you.
When working with private insurance companies, their employees may make a judgement about your therapy needs without knowing you. They may have limited knowledge about your specific disorder or condition or treatment methods available. I partner with you to create a treatment plan that is customized to your goals and based on most current research.
3. Only you know when you are ready to end therapy.
Insurance companies may limit or deny your benefits with little consideration for your actual needs, despite recommendations of expert healthcare professionals. Research shows therapy is most effective when sessions are consistent and opportunities for practice in a supportive environment are provided. Frequent and unnecessary breaks in therapy should not be dictated by insurance mandates. Only through purposeful consideration of the treatment plan developed together with the speech-language pathologist.
4. Insurance contracts take valuable time away from your plan of care.
We all want to be good stewards of our money and insurance companies often do their due diligence in ensuring healthcare dollars are spent frugally and intentionally. This is a good thing. However, as a licensed speech-language pathologist and in collaboration with a physician, I am able to report my findings as the expert without depending on private insurance approval. We can offer evidence-based treatment methods proven to be successful without insurance restriction. Our training includes knowledge and skills to treat patients with the highest quality care. I will not compromise care to suit insurance needs.
How to Save Money on Therapy
If you’re thinking, “Great! But how in the world can I afford out-of-network therapy??” here’s some suggestions to consider saving money while using your out-of-network insurance benefits.
- Ask questions about your specific insurance plan and benefits (see below).
- Your out-of-pocket medical expenses can be reduced if your employer offers a pre-tax medical flexible spending account or if you have a health savings account (HSA).
- Ask your accountant about taking a medical tax deduction for your therapy needs.
- You may save money with an insurance plan that has a higher premium, but better benefits for out-of-network therapy. Ask about a Preferred Provider Organization or PPO.
- Talk with your local speech-language pathologist about payment options available or resources in the community to supplement your out-of-network therapy.
- Advocate for your needs; don’t give up! Insurance companies aren’t trained healthcare professionals. They may not know what your condition or disorder requires for treatment.
Call your insurance company to ask these essential questions about your out-of-network benefits:
- Does my policy plan cover a licensed speech-language pathologist who is out-of-network?
- My speech-language pathologist only reports session dates, CPT codes, diagnosis, and payment. What other information is required?
- What percent of the allowed amount will you cover?
- What is my out-of-network deductible and co-payment?
- Does my policy cover charges for missed or cancelled sessions?
If you still have questions about therapy and your out-of-network benefits, contact us to discuss your options. We look forward to partnering with you and providing the highest quality treatment to meet YOUR needs.