More About the Benefits of Avoiding Insurance

First, I want to say that health insurance is extremely important for so many reasons, but it can be too much hassle for what it’s worth when it comes to speech therapy.

Second, yes, super boring stuff, but knowing your way around it can save you a lot of money. Here are some perks if you decide to bypass your insurance company.

♥  If you have a health insurance plan with a high deductible, there’s a chance you’ll be paying out-of-pocket before the insurance even kicks in.

♥  I learned from my time working in hospitals, most insurance companies greatly limit the number of sessions you can have within a certain period; you could get limited to only 12 sessions a year (that’s only 3 months if you meet once a week)

♥  Some insurance companies cap how much they’ll payout for a particular service. In other words, you could get cut-off before the therapy is complete.

♥  Some insurance companies say they’ll reimburse you for the service, and then later inform the Speech Therapist that services won’t be covered because it’s not “medically necessary”. This leaves it on the SLP to present you with a large (and unexpected) bill.

Insurance is great and everyone should have it, but there are some things that work better without it. As always, do your own research to find out what is best for you and your personal situation. The information above reflects my personal opinion and should not be construed as financial advice or a medical recommendation.

No Surprises Act and Good Faith Estimates

Beginning January 1, 2022, if you’re uninsured or if you opt for self-pay (i.e., not going through your health insurance), health care providers like Healthy Speech Solutions must provide the patient or legal guardian with an estimate of the expected charges before you get an item or service. This is called a good faith estimate. Providers and facilities (like Healthy Speech Solutions) must provide you with a good faith estimate if you request one, or after you’ve scheduled a new service. The good faith estimate should include the expected charges for all items or services that are provided as part of the same scheduled experience. The provider must provide a list of all items and services associated with your care.

For more information, please visit the Centers for Medicare and Medicaid Services (CMS) website at www.cms.gov/nosurprises.