American Speech-Language-Hearing Association

Health Plan Speech, Language & Hearing Coverage Form

The goal of this project is to obtain information about the coverage of speech, language, and hearing services by private health insurance plans, not Federal programs such as Medicare or Medicaid. If the only health insurance you are insured under is Medicare or Medicaid, please do not respond to the questionnaire.

* indicates required field.

Name of Health Plan:

Type of Health Plan:

Coverage of Speech and Language Services

Different health plans put information on the coverage of speech and language services in different places in the Summary of Benefits. To determine your health plan's coverage of speech and language services, you may need to look under:

  • Speech-Language Pathology
  • Speech Pathology
  • Speech Therapy
  • Physical Therapy and Other Rehabilitation Services
  • Other Medically Necessary Services or Therapies

Even if you can't answer all of the questions, any information you provide will be helpful.

Does your health insurance plan require a co-pay for speech and language services?

*If yes, what is the amount of the co-pay?

Does your health insurance plan cover speech and language evaluations?

Does your health insurance plan cover speech therapy sessions?

Does your health insurance plan cover speech therapy for developmental delays?

Does your health insurance plan cover electronic communication devices (e.g., artificial larynx, AAC) (may be under Coverage of Prosthetic Devices or Durable Medical Equipment)?

Limitations to Coverage

Limitations and exclusions are typically located in a separate section of the Summary of Benefits often referred to as Things We Don't Cover or Exclusions to Coverage.

Does your health insurance plan limit coverage of speech therapy to only when it is needed due to accident or injury?

Does your health insurance plan limit the number of speech therapy sessions?

*If yes, what is the limit?

Does your health insurance plan limit the dollar amount that they will pay for speech therapy sessions?

*If yes, what is the limit?

Provider Accessibility

Does the health insurance plan require that you obtain prior approval or that a physician "prescribe" speech and language services?

Does the health insurance plan include speech-language pathologists as in-network providers?

Coverage of Hearing Services

Different health plans put information on the coverage of hearing services in different places in the Summary of Benefits. To determine your health plan's coverage of hearing services, you may need to look under:

  • Hearing Care
  • Audiology
  • Other Medically Necessary Services or Therapies
  • Diagnostic Services

Even if you can't answer all of the questions, any information you provide will be helpful.

Does your health insurance plan require a co-pay for hearing services?

Does your health insurance plan cover routine or preventive hearing services?

Does your health insurance plan cover hearing testing needed due to accident or injury?

Does your health insurance plan cover hearing (audiologic) therapy sessions?

Does your health insurance plan cover hearing aid devices?

*If yes, provide details on the coverage (e.g., $500 hearing aid allowance every 2 years).

Does your health insurance plan cover earmolds for hearing aid devices?

Does your health insurance plan cover cochlear implant devices (may be found under Prosthetic Devices or Durable Medical Equipment)?

Limitations to Coverage

Limitations and exclusions are typically located in a separate section of the Summary of Benefits often referred to as Things We Don't Cover or Exclusions to Coverage.

Does your health insurance plan limit the number of hearing (audiologic) therapy sessions?

*If yes, what is the limit?

Does your health insurance plan limit the dollar amount that they will pay for hearing therapy sessions?

*If yes, what is the limit?

Provider Accessibility

Does your health insurance plan require that you obtain prior approval or that a physician "prescribe" hearing services?

Does your health insurance plan include audiologists as in-network providers?

How did you learn about this questionnaire (check all that apply)?

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