Anyone else not have OT/PT/SPEECH covered by insurance?

justforfun87

Mon, Feb 05 2018, 7:46 pm

I have blue cross/blue shield but apparently they won't cover my son's speech because he it is not a congenital/rehabilitative service. The hospital I work for apparently waived that coverage. No one I know has to pay privately for these services. What am I missing? 75 dollars for 30 mins?? Help!

loveit

Mon, Feb 05 2018, 7:54 pm

Try jfs, they offer a sliding scale in our area. I’ve never had insurance cover these services either. Actually that’s not true, they were covered once you hit the deductible ($3000-6000 depending on our plan that year) but it was limited to certain number of sessions. So pretty much not covered. I’ve never heard of anyone getting it for free unless they qualified for EI

Mommyg8

Mon, Feb 05 2018, 8:07 pm

I'm on private insurance, and they cover a grand total of.... five dollars a session.

I think Medicaid always covered more.

And sometimes people get these services through the Board of Ed, which is obviously free.

amother

Lavender

Mon, Feb 05 2018, 8:16 pm

justforfun87 wrote:

Is JFS just a NY organization?

We have JFS and live no where near NY or anywhere near the northeast for that matter so they are all over

justforfun87

Mon, Feb 05 2018, 8:32 pm

We get one 30 min through the Board of Ed but he needs more. For now we are thinking that it is what is contributing to the phonic awareness issues now he is in Kindergarten. He has been getting speech for years through Board of ED but due to county logistics, they cut it down. Did JFS give you money towards it or you had services done there?

amother

Lavender

Mon, Feb 05 2018, 8:52 pm

justforfun87 wrote:

Our JFS send it’s therapists in to work with the students at all the Jewish schools which is really nice. Especially since we live in an area where the state offers almost nothing to private schools for anything

amother

Babypink

Mon, Feb 05 2018, 9:02 pm

We bh got OT covered thru insurance.
Which is suprising. Because my kids delay isn't so much in gross/fine motor skills. Her issue is impulsively, and very bad sensory. Very likely AD(xH)D. And the therapist has didn't think she was gonna get anything from insurance.
We would have paid for bit had insurance not covered it.
We are going tomorrow so I'll find out how much of the visit they cover and how many visit....

mha3484

Mon, Feb 05 2018, 9:02 pm

Look to see if any local universities have clinics they often have a sliding scale if you don’t mind using grad students.

amother

Cobalt

Mon, Feb 05 2018, 9:44 pm

mha3484 wrote:

Look to see if any local universities have clinics they often have a sliding scale if you don’t mind using grad students.

I was just going to suggest this. Graduate students are very closely supervised, so in essence you are receiving therapy from the supervisor, who is is usually a highly experienced SLP. I’m an SLP, and I remember when I was in school I had to write a detailed plan for every session, with evidence-based rationales. My supervisor observed the entire session, and joined the session when she felt I needed guidance.

saw50st8

Tue, Feb 06 2018, 7:35 am

Mine used to cover it. I got a huge surprise last year when my company removed the coverage and didn't notify me. It's costing me $10,000 for the therapy my daughter needs.

smileyfaces

Tue, Feb 06 2018, 1:55 pm

Would it help if the pediatrician wrote a letter for you explaining why your child needed it?
Is that specific provider not in network, or do they not cover speech at all?

observer

Tue, Feb 06 2018, 2:19 pm

Most of ours is not covered, they agreed to cover a few sessions only. Costing us a fortune which we don't have (yet) Wink

amother

Brown

Tue, Feb 06 2018, 2:47 pm

I have private insurance and it's not covered. I'm paying $65 for a half hour of speech therapy a week.

On the other hand, my daughter qualified for therapy through the board of ed, so she gets an hour of PT and OT for free.