Frequently Asked Questions

While an insurance plan may provide benefits for occupational, physical or speech therapy, the coverage is often very specific as to what they will cover and for how many visits. 

Common exclusions and limitations may include: 

•    Exclusions for diagnoses related to developmental delay or learning disability. 
•    Speech coverage only for children under three years of age. 
•    Coverage for therapy only when therapy is required due to injury, stroke, Autism spectrum disorders, trauma or congenital condition. 
•    A limitation of the number of therapy visits per year or per authorization. 

Some plans require a referral and/or “pre-authorization” where the services you wish to receive must be approved by your carrier in advance. This may be required once for the duration your child receives therapy, once per year, or per each block of visits granted.

Many larger companies and institutions with thousands of employees are "self-funded" and set the scope of coverage for their employees. The insurance carriers used by those companies are administrators who merely manage claims. The reimbursements for the claims paid out come from a pool of funds held by that company or institution. The benefits for a particular type of service may be better or worse than the generic plans offered by your plan's third party administrator. The first step in establishing benefits is to speak with your company's HR department to get the correct contact information for your plan's 3rd party administrator.

AAC is a term that encompasses all types of non-oral communication. It can be visual such as facial expressions, gestures, pictures or writing. People with severe speech and language problems often rely on different forms of AAC to communicate with those in their environment.

Many people can benefit from the use of low tech or high tech AAC devices and equipment. Patients with Cerebral Palsy, Stroke, Down's Syndrome, Traumatic Brain Injury, and Amyotrophic lateral sclerosis (ALS) can benefit from devices to aid in communication, access their environment and access online tools such as internet browsers and email. Children with severe oral motor incoordination and weakness such as Apraxia, Cerebral Palsy, Down's Syndrome, Austim Spectrum Disorders and patients who are nonverbal or very limited verbal abilities can also benefit from AAC.