Does my insurance cover the cost of a speech and language evaluation?

In general, most insurance companies may cover speech and language testing that is deemed “medically necessary.” This is determined on an individual basis by the insurance carrier and requires an order for the evaluation from a medical practitioner. The referring provider can be the child’s primary care physician, neurologist or other medical doctor. Beacon will make every effort to support a family by completing the referral and pre-authorization paperwork if they seek to access their medical benefits for the evaluation.

It is important to note that not all insurance companies contract with Beacon and not all cases are approved for testing. However, a family may elect to pay for the testing at the out-of-pocket rate and apply for reimbursement on their own through their insurance company after the evaluation, although this does not guarantee reimbursement. 

One of the most frequent reasons why an insurance carrier may deny testing would be if this benefit has been accessed by another plan within the last 12 months.