header Health Insurance

Speech Therapy Coverage Under Health Insurance Policies in India

By Juhi Walia
30 August 2022, 4:59 PM

Speech therapy is an effective way to overcome many communication and speech disorders such as articulation disorders, fluency disorders and stammering, receptive disorders, expressive disorders, cognitive communication disorders and others. It is, however, prohibitively expensive for the average Indian. Keeping this in mind, it is good to factor in speech therapy coverage while selecting a health insurance policy for yourself or your loved ones.

If you have no speech disorder, you may wonder whether this is at all necessary. However, remember that speech disorders are not only congenital but can arise at any time due to accident or illness. The good news is that speech therapy related expenses are covered by many health insurance providers in India. The coverage offered against speech therapy, however, varies from plan to plan.

Conditions Under Which Speech Therapy Costs are Covered

Some plans offer speech therapy cost coverage only for children and persons between three and twenty five years of age. Some policies may cover speech therapy-related expenses if the requirement arises out of a medical condition only. Development-related speech therapy disorders will not be covered under such policies.

Others cover the cost of speech therapy if the related disorder occurs due to an accident or illness as part of the post-hospitalisation expense coverage. Sometimes, this coverage is provided through the critical illness add-on cover. However, the diagnosis must prove that speech disorder results from a critical illness.

Waiting Period

As with most health insurance policies, this coverage of expenses against speech therapy can only be availed after the end of the waiting period specified in your policy document. This could be anywhere between thirty days and upwards.

For an adult diagnosed with a communication disorder requiring speech therapy due to a chronic disease, the waiting period under the critical illness plan may be 90 days or more. If the disorder needing speech therapy is classified as a pre-existing medical condition, the waiting period may be anywhere between two to four years.  Some policies may also specify a mandatory co-payment.

You may want to clarify the conditions under which speech therapy-related expenses are covered by the health insurance plan before picking the best plan.   

Supplementing Speech Therapy Sessions Under a Trained Practitioner with Sessions at Home

Even though your health insurance policy covers speech therapy-related costs, you may find that it will not cover the entire cost due to the expensive and prolonged nature of treatment. You also may not be in a position to spend hours on travel to take your child or family member to the therapist’s chamber for daily sessions. In such a case, you might consider supplementing the sessions with the speech therapy sessions at home.

While this may sound daunting at first, you can use several simple techniques to augment the sessions provided by the trained speech therapist. These include:

-  Keeping the child/patient in front of the mirror and making him/her enunciate the words slowly after you.

- Have reading sessions as per the level of the child or patient. Make these sessions more interesting by reading aloud as well.

- Making the child blow air into straws. It helps build muscular strength of muscles vital to clear speech. You could also include balloon-blowing sessions, especially if the child/patient is young or children are around to enjoy playing with the balloons.

-   Have singing sessions.

-   Be sensitive to the challenge faced by your child/patient. Never make fun. Sensitise those who do so, even if this is meant as harmless fun.

Conclusion

While checking for critical illness coverage under various medical insurance plans is commonplace, the need for speech therapy cost coverage is often forgotten or neglected. However, as the ability to communicate effectively is vital for our social and psychological well-being, speech therapy coverage under health insurance needs is paramount while evaluating the different policies available in the market. If you already own a medical insurance policy, now would be a good time to check to see if this cost is covered. If it is not, you may wish to look to upgrade your plan or port to a service provider that offers such coverage.

Read more-

FAQs

1. Does a critical illness add-on cover speech therapy costs?

It does, provided speech disorder is due to a critical illness. A valid diagnostic report must confirm the same. The critical illness add-on cover is usually provided at an extra premium to help cover the cost of serious illnesses, which may require extremely expensive and/or long-term treatment not covered under a basic health insurance plan. Under this, coverage is provided for up to 36 major critical illness such as kidney failure, cancer, etc

2. What if I have a speech disorder before buying a health insurance policy?

It will be regarded as a pre-existing illness, so there will be a waiting period of up to 48 months. Afterward, the insurer will cover the same. Even if you don’t have such a disorder, the insurer can place certain waiting periods, making it imperative for you to read the policy wordings.

3. Do I really need to factor in coverage of speech therapy related costs while selecting a health insurance policy?

The 2011 census reports more than seven million people with communication disorders in India. A good proportion of these arises due to medical illness and accidents. Therefore, yes, it would be good to consider coverage of speech therapy-related costs while selecting your health insurance policy.

4. If I decide to take a risk and take a policy that offers no coverage of speech therapy-related costs, what are the implications?

Speech therapy can be prohibitively expensive. A single session can cost from INR 500/- upwards. A more seasoned and experienced practitioner’s fee could be in the range of INR 3,000/- or above, taking the monthly cost to at least INR 60,000/- depending on the number of sessions – not an affordable cost for the average Indian. In many instances, the treatment period may be prolonged and last for months - till there is no more expectation of further benefit from the therapy. So, ensure your policy has this and several other coverages.

5. Will I have to contend with a co-payment clause if found to have a speech disorder when buying a health insurance policy?

Younger lots don’t necessarily need to contend with a co-payment clause, regardless of whether they have a disease or not. But it will depend on the insurer. If it feels like applying a co-payment clause after knowing you have a speech disorder, it can do so. Co-payment is the percentage of the medical treatment cost the insured is expected to pay from his or her own pocket, while the balance can be claimed with the medical insurance service provider. Some policies come with a mandatory co-payment option, while others come with a zero co-payment mandate. A zero co-payment policy is usually comparatively more expensive than a policy requiring a mandatory co-payment.

Health Insurance banner
Health Insurance

Plans starting at only ₹7/day*

Enter your details to buy Health Insurance
By proceeding, I agree to the Terms & Conditions