Speech therapy in private health insurance: language, speech and voice therapy

The chain of reimbursement has three links. You need a doctor's prescription with a diagnosis, a qualified therapist and a plan that covers therapeutic remedies. Typical reasons are delayed language development in children, articulation and fluency disorders such as stuttering, voice disorders in teachers and other speaking professions, and language and swallowing disorders after neurological diseases.

Speech therapy is prescribed in series. Common are ten treatments per prescription, with a follow-up prescription if needed. In most plans, approval by the insurer before therapy starts is not necessary. For therapies that will clearly take a long time, for example after a stroke, a written confirmation of cover is still advisable.

An individual speech therapy session of 45 minutes costs €35 to €70 privately, depending on the region and the practice. Providers of therapeutic remedies are not bound by a state fee schedule. They set their private prices themselves. This is exactly where the most common out-of-pocket share arises. Plans that reimburse therapeutic remedies only up to fixed maximum rates do not always fully cover the freely set fee.

High-performance plans instead word the reimbursement as an appropriate or customary local amount. In the plan comparison, this wording belongs on the checklist, especially for families. All amounts are guide values. The plan is binding.

From more than 5,000 applications with health questions, we know that speech therapy in childhood is common and as a rule goes well. For the child's insurance, ongoing speech therapy must also be stated in the application and, depending on the insurer, leads to a postponement or a surcharge. We recommend that parents in this situation make an anonymous risk enquiry before an application is submitted.

In an existing contract, speech therapy is straightforward: secure the prescription, collect the bills and submit them. For therapies that run over several prescription series, a direct line to the insurer is worth it, so that follow-up prescriptions go through without discussion.

As many as are prescribed by a doctor and medically justified. There is no statutory upper limit as in the remedies catalog of the statutory health insurance funds. Some plans limit the number per year. The doctor's prescription sets the pace.

Teletherapy is now established and is reimbursed by many plans if the prescription allows it and the therapist is qualified. For small children, professional suitability decides in the individual case, not the insurance question.

A diagnosed voice disorder is an illness, so its therapy is medical treatment, even if the job is the cause. Pure voice coaching without a diagnosis, by contrast, is not medical treatment and remains at your own expense.

No. Speech therapy is a prescribed therapeutic remedy and is covered by the therapeutic remedies part of the plan, separate from naturopathic treatment and its annual limits.