Jamie Said:

Speech Therapy and Insurance Coverage?

We Answered:

Each insurance policy is different, unfortunately only your insurance company can tell you what is covered on your specific policy. If you have the insurance through your employer try asking the human resources department to look into it for you, they usually have a specific contact for the policy and can probably get better answers.

On another note though, I would look around for a different speech therapist - my son was evaluated at the end of last year and the fee for the initial consultation was only $160. His therapy sessions are $44 for half an hour.

Hope this helps - Good Luck.

Andy Said:

insurance company denied claim, speech therapy for 5 year old?

We Answered:

You've already answered your own question. That your policy does not cover the cause of your daughters speech impediment.

I'd talk to management and see if they can review and pay the bills up until the time they notified you that the service was not covered. You may be able to appeal that. Make the argument that since they paid the prior bill you relied on that and continued treatment.

But as others have pointed out, you run the risk of them looking at you to pay them back for treatment they already paid for.

There is no way to make them cover the bills after they notified you that the treatment was not covered under your new policy. You will have to pay for that out of pocket.

See if your daughter can get speech therapy through the school system.

Cynthia Said:

What does an approved provider mean to health insurance company?

We Answered:

Go to Health Insurance Help. This site has detailed information on how to evaluate insurance and defines many insurance terms.

Peter Said:

What is the best way to ask employer to include coverage for speech and occupational therapy in health plan?

We Answered:

Keep in mind that if (and that's a big IF) you can convince them to cover the treatments, the earliest you'd probably have coverage available would be 2011.

This late in the year, its certainly too late to get any major changes approved for the 2010 benefit year. Open enrollment time would be coming up soon, and the plans should be set in stone by now. Plans, rates, and coverage have to go through a lengthy approval process. Not enough time to make changes to be effective in 2010.

If you're still interested in petitioning for changes to the 2011 benefit plan, your wife should start with her HR/benefits office.