Understanding Your Health Insurance Coverage

Types of Health Plans

Before you can find out what your health insurance covers, it’s important to know what kind of health plan you have. Most plans fall into one of four categories.

Private Health Plans

• These plans are the most common. They’re often provided by employers, but people can also buy them on their own.

Medicaid

• This government program helps cover health care for people with low incomes and their families. Each state has its own rules about what services it covers and who qualifies for the program.

Medicare

• This government program provides health care for people who are 65 or older, and for some younger people with certain disabilities.
• Find out if Medicare covers your test, item, or service.

Military Health Plans

• The U.S. Veterans Administration (VA) covers veterans, military retirees, active-duty service members, and their families.
• TRICARE provides health coverage for eligible service members, retirees, and their families.

Other Sources for Health Care Assistance

If your health insurance doesn’t cover speech and hearing services, there are other sources for health care assistance.

School-Based Hearing, Speech, and Language Services

The Individuals with Disabilities Education Act (IDEA) is a federal law that provides a free, appropriate, public education for all children with disabilities. Through IDEA, your child can receive speech, language, and hearing services in their public school, but only if the services support the child’s ability to benefit from education.

• IDEA Part B supports children ages 3–21.
  • Services are provided as outlined in the Individualized Education Program (IEP).
  • An IEP is a plan created by families and school teams to support the child’s learning and development.
• IDEA Part C supports infants from birth–2.
  • Services are provided as outlined in the Individualized Family Service Plan (IFSP).
  • An IFSP focuses on early support in the child’s natural environments—like home or childcare.

Through these plans, families and professionals work together to support each child’s unique needs.

Help Paying for Hearing, Speech, and Language Services

Paying for care can feel overwhelming—but support is available. State and national programs may help cover the cost of:

• Hearing tests and hearing aids.
• Speech-language services.
• Assistive technology like communication devices.

You Can Help Create Change

Improving health care legislation takes persistence and teamwork — but it’s possible. If you want to make a difference in your state, start by connecting with others who share your goals.

• Set clear goals and priorities for what you’d like to change.
• Partner with other dedicated volunteers.
• Engage in outreach
  • Contact your state speech, language, and hearing association.
  • Get in touch with the American Speech-Language-Hearing Association’s (ASHA) State Advocates for Reimbursement.
  • Contact your elected officials, including governors and state legislators.

You can help improve access to communication care in your state. While advocating for better coverage can take time, with strong leadership and consistent effort, your voice can make a real impact.

Additional Tools

Private insurance, Medicare, and Medicaid coverage policies change often. To learn more about how to influence change in your plan check out the additional tools below:

• Talk to your employers about providing private health insurance coverage that meets your needs, including comprehensive speech, language, and hearing benefits.
• Become an advocate for improved coverage at the state level.
• Learn about ideal health plan coverage for speech and hearing services, according to the American Speech-Language-Hearing Association (ASHA).