Does Medicaid Cover Speech Therapy?

Speech therapy is considered an optional Medicaid benefit, which means that each state can determine if it will cover the service for its beneficiaries, as well as the guidelines under which it's covered.

What Does Medicaid Cover for Speech Therapy?

The exact speech therapy coverage that you can access as a Medicaid beneficiary depends on where you live. In most cases, Medicaid benefits will cover the cost of speech therapy services when medically necessary. That means if you or another member of your Medicaid plan have a speech, hearing or language disorder, your plan may help cover the cost of speech pathology services, as well as related services such as audiology or hearing tests. In some cases, children may also be covered when they require speech therapy for fluency, resonance or expressive disorders.

In some states, coverage is limited to those who are institutionalized, such as seniors who receive nursing home care or are under long-term hospitalization after a stroke.

Which State Medicaid Plans Cover Speech Therapy?

Medicaid coverage for speech therapy varies quite a bit from state to state. While some, such as Texas, Virginia, Maryland and Georgia, don't offer any coverage for speech therapy, others have limitations on how much can be spent on speech therapy in a calendar year or how many times you can visit a speech pathologist or audiologist. For the exact coverage you receive, it's normally best to check with your state's Medicaid agency. 

Out-of-Pocket Costs

If you're living in a state with Medicaid coverage for speech therapy, you might be required to make a copayment when you receive speech pathology services. Typically, this amount is just a few dollars per visit. 

Additionally, if you've exceeded the limitations of your state's Medicaid coverage, you may be required to pay the full cost of your visits with a speech-language pathologist. This cost varies depending on the state and health care provider. 

Is Speech Therapy Expensive? 

According to Costhelper Health, average speech therapy costs in the United States are $200 to $250 for an assessment, and follow-up visits can range from about $100 to $250 per hour. These costs can vary depending on the clinic you visit, and the length of your sessions can vary depending on the condition that's being treated and its severity. It's important to discuss these costs upfront prior to booking your first appointment if your Medicaid agency doesn't cover this service.

Does Speech Therapy Really Work? 

Studies have shown that regular speech therapy is effective. According to a 2011 study published by the International Journal of Language and Communication Disorders, an average of six hours of speech and language therapy administered over a six-month period resulted in significant improvements for children with speech or language impairments.

In adults and seniors who've suffered a stroke or another event that resulted in speech/language problems, studies on the efficacy of speech therapy have produced similar results. 

Does Medicaid or Medicare Pay for Voice Therapy?

When a child speaks with a stutter or has other fluency issues, they may require voice therapy to help them speak more clearly. These services may be covered by Medicaid, depending on the state. Typically, they're covered under the same parameters as speech pathology. 

Medicare Part B also typically pays for voice therapy. Again, it's important to check with your plan provider to determine if you're eligible for coverage and how much coverage you can receive.

Does Medicare Cover Speech Pathology?

In most cases, speech pathology is covered under Medicare Part B plans. As with voice therapy, it's important to check with your plan provider for confirmation and details.