When it comes to children, Speech Therapy is almost always a 'habilitative' service, that is, it helps a person learn, keep, or improve skills and functional abilities that they may not be developing normally. As opposed to a 'rehabilitative' service which focuses on regaining skills and abilities lost to injury or illness (ie: broken jaw or stroke).
Why does this matter? Most insurance companies in WA State have two categories for Speech Therapy (one for 'rehabilitative' and the other for 'habilitative' services called 'neurodevelopmental therapy') and the benefit's for each differ severely. Neuro-therapy is typically only covered for children six and younger. So at a time when a child may need Speech Therapy the most their benefits are cut off and the parents are forced to pay out of pocket or more likely stop receiving services.
Recently a U.S. District Court judge ruled that Group Health of WA must remove age restrictions on certain neurodevelopmental therapies! Lawsuits are also pending against Premera Blue Cross and Regence Blue Shield.
This has also gained the attention of the federal agencies that are developing regulations for the Patient Protection and Affordable Care Act, health care reform legislation starting in 2014. Hopefully we will see this age restriction removed on all insurance plans nationwide so that our children can continue receiving the services they need to flourish!