Checking Your Member Benefits

Visit your insurance company’s website and log in to your personal account.  Look for one of the following sections under “Benefits & Coverage” to determine if speech and language services are covered for your child:

  • Speech and Language Benefits
  • Speech-Language Pathology
  • Speech Pathology
  • Speech Therapy
  • Physical Therapy/Other Rehabilitation Services
  • Medically Necessary Services or Therapies
  • Rehabilitation Services (Occupational Therapy, Physical Therapy, Speech-Language Therapy)

Read your plan carefully.  Sometimes insurance companies will not pay for certain services (i.e.,”limitations and exclusions”), or will only pay for services under certain circumstances (i.e., if your child is already diagnosed with a certain medical condition).

Before Your Child’s First Session

Check your policy to determine if there are any steps you need to take before your child’s first session to receive reimbursement for services.  If your insurance plan covers speech and language services, you may have to get approval before your child’s first session.  This may involve:

  • Getting written authorization from your health plan
  • Getting a referral note/prescription from your child’s doctor

If you have speech and language therapy benefits, complete the “Insurance Information” section when filling out intake forms for your child.  At the end of the month, an invoice for your child’s therapy sessions will be emailed to you.  After your monthly balance is paid in full to Building Blocks Speech Language & Literacy, your child’s therapist will provide you with an insurance invoice that includes the necessary codes and information needed to authorize reimbursement for services directly to the insured.

Coverage for Children with a Related Medical Diagnosis

In the state of Maryland, insurers, nonprofit health service plans, and health maintenance organizations are required to provide coverage for habilitative services to children under the age of 19 years who have a congenital or genetic birth defect, including autism.  Habilitative services include occupational therapy, physical therapy, and speech-language therapy.  (MD Insurance Code Ann § 15-835)