Is Speech Therapy Covered by Health Insurance in India?


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Updated on Apr 30, 2023

For most of us, we feel an optimum level of freedom when we can express ourselves through words. Also, when it comes to complimenting someone or making a complaint, we use words only. This shows the importance of words and speech. However, life is not so fair to everyone and there are some children as well as adults who develop speech and communication disorders. For them, the only way out is speech therapy. So, today, let us discuss speech therapy and also learn if health insurance covers them.

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What is speech therapy?

Speech therapy is used for the treatment of communication and speech disorders. This therapy is effective for treatment among kids who developed speech disorders in their childhood. Apart from this, speech therapy is also helpful for the treatment of adults who have developed speech impairments as a  result of illness, injury, or surgery like a stroke or brain surgery.

This kind of therapy is performed by a speech therapist, who is also called a speech-language pathologist.  There are several types of speech therapy techniques used by speech therapists. The techniques are articulation therapy, language intervention activities, and many more. These techniques are used on the basis of the kind of communication and speech therapy one has.

Communication and speech disorders treated with speech therapy

While speech therapy is certainly effective for treating speech disorders; however, the speech therapy technique depends on the kind of speech disorder an individual has developed. Here are some of the types of communication speech disorders mentioned below:

  • Dysarthria
  • Aphasia
  • Articulation disorders
  • Fluency disorders
  • Receptive disorders
  • Cognitive communication disorders
  • Expressive disorders
  • Resonance disorders.

Is speech therapy affordable?

In a country like India, speech therapy does not fall under the affordable category. A single consultation with a speech therapist on average can cost you around INR 3000. You also need to know that it is not a single or two times session. Speech therapy is carried out for months and even years, if need be. So, it can actually be quite costly, at least for people who have a single earning source in the family.

This is one of the main reasons why many people opt for health insurance that covers speech therapy, especially the ones who need it.

Is speech therapy covered by insurance?

The answer to this question is ‘yes’. Many health insurance policies provide coverage for speech therapy. Well, this does not mean that you can choose any health insurance policy and expect it to cover speech therapy costs. While some health insurance policies provide coverage on the charges incurred on the consultation with a speech therapist, some other health insurance plans cover speech therapy costs only for children or adults. Nevertheless, if the speech disorder is the result of a critical illness, the cost of the speech therapy will be covered under a critical illness insurance policy.

You can even come across health insurance policies that offer speech therapy covered under post-hospitalization costs or OPD cover. In the case of a health insurance policy that covers speech therapy for children, there is an age range, which starts from 3 years and goes up to 25 years. Some policies offer the option of a co-payment of 20% on each claim. Therefore, before you buy a speech therapy health insurance policy, you must read the terms and conditions very carefully.

How to get speech therapy covered by insurance?

This may come to your mind especially when you need your or your child’s speech therapy to be covered by your insurance policy. However, you do not need to worry if you have read the terms and conditions of the health insurance policy you have bought and you found the coverage of speech therapy mentioned in the policy papers. Well, the only things that you need to do are discussed herein below:

Understanding the requirement

While you are planning to buy a health insurance policy so that it can cover speech therapy, you first need to understand the clauses that are mentioned in the policy papers. Also, you may need to go through several steps to get the coverage.

Getting a medical diagnosis

To get coverage for speech therapy, you need to get a medical diagnosis done which clarifies that the therapy is medical and not developmental. You might need to get the diagnosis done and your doctor should clearly mention that speech therapy is needed.

Including a personal letter

You as a parent may need to add a personal letter in which you can emphasize the medical nature of your kid who needs the therapy.

What if the coverage is denied?

You may receive a denial of coverage since this is not something uncommon. However, do not get upset and do not take it as the final answer from the insurance company. You need to be persistent and check the denial letter. You should also check the diagnostic papers that you submitted and if it mentioned that it is a neurological code and not a developmental delay. If need be, you can get it written by the speech therapist.

You can also ask about the appeal process of the company and prepare yourself to go through it. You may have to submit everything in writing and maintain a record with the insurance company very carefully. You can also try to ask the company the reason for their denial.

There are several health insurance companies available in India that offer health insurance policies covering speech therapy. All that you need to do is to go through the terms and conditions thoroughly and see if the policy is what you need.

Read More: How Can You Get Free Medical Check-Ups Under Your Health Insurance?

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