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Does Medicare Cover Speech Therapy?

    What is Speech Therapy?

    Speech therapy, also known as speech-language pathology, is a health service that can help people improve their voice, speech, and language skills. Additionally, this type of therapy can also help retrain a person to properly swallow in the event that a stroke (or similar medical condition) has impaired it. Speech therapists, or speech-language pathologists (SLPs) are especially trained to provide this treatment. 

    Though speech therapy is often beneficial for adults who have suffered a brain injury, illness, or muscular disorder, it may also be used to help someone overcome a speech disorder that developed in childhood.

    But what if you’re a senior on Medicare in need of speech-language pathology? Is this type of therapy covered under your Original Medicare plan?

    Does Medicare Cover Costs Associated with Speech Therapy?

    Like with most treatments and services that focus on specialized conditions and recovery, Original Medicare typically will only cover costs associated with speech-language pathology in the event that it is deemed medically necessary by a doctor.

    That said, Medicare Part B may help cover the costs of speech therapy that is designated as part of an outpatient therapy program. This means that a person may be required to pay the Part B deductible, in addition to a coinsurance of around 20 percent, if they expect to receive assistance paying for speech therapy as part of an outpatient recovery program.

    Still, if the costs associated with speech therapy exceed a certain amount, a medical report may be required before further treatment can be authorized.

    How do I become eligible for Medicare Part B coverage for outpatient speech therapy?

    A person may be eligible for Medicare-covered outpatient speech therapy services if the following conditions are met:

    • They require skilled therapy services and a healthcare provider decides that the service may provide safe, effective treatment for the health condition 
    • A doctor or therapist provides a written plan of care before the person starts their treatment 
    • The plan of care is updated or changed as needed 

    If a person meets the requirements for SLP services, Medicare may provide coverage, whether the health condition is temporary or long-term.

    What can I do to ensure my most important healthcare needs are covered?

    While Original Medicare plans are beneficial in many ways, one of the best ways to ensure that you are covered for your specific medical needs is to enroll in a Medicare Advantage, or Medicare Part C, plan.

    Medicare Advantage is a form of Medicare health insurance coverage that is not only legally required to offer the same level of coverage as Original Medicare, but also often offers coverage for medical treatments and services beyond the scope of Medicare Parts A and B.

    Though Medicare Advantage plans are offered by private insurance providers, meaning their exact pricing, availability, and benefits may vary, one can typically expect a Medicare Advantage plan to offer coverage for common healthcare needs such as vision, dental, and hearing care.

    Some plans may even offer expanded coverage for speech-language pathology services. If you’re interested in exploring your Medicare Advantage options, don’t hesitate to contact the Medicare Advantage experts and licensed insurance agents at today!