This article may just help you discover and find out how you as a consumer can understand
your health insurance plan as well as provide further contacts to assist you in understanding
and obtaining the health insurance coverage you need to receive speech and hearing services.

TYPES OF HEALTH INSURANCE PLANS AVAILABLE

In order to understand your health insurance coverage, you must first be able to identify what
type of health plan you may have. There are 3 different health plans available to consumers:

PRIVATE HEALTH INSURANCE PLANS AVAILABLE

Typically, a health insurance benefit plan is a contract between your employer and a third party
(an insurance company). These contracts vary widely depending on the benefits and coverage
levels negotiated by your employer. Oftentimes, the benefits information provided by your health
insurance plan is confusing-leaving you unsure of what speech and/or hearing services will or
won't be covered.

Remember, the benefits booklet you receive is merely a summary of benefits-not actual contract
language. You may need to examine the policy or contract to truly understand your health
insurance plan's coverage and limitations. The policy or contract can be obtained from your
benefits manager. It is vital that you review the speech and hearing benefits information
provided by your health plan and employer before you receive services.

MEDICAID

Medicaid provides medical assistance to certain individuals and families with low incomes and
resources. It is jointly funded by the Federal and State governments. Although the federal
government establishes national guidelines, each state has the authority to establish its own
eligibility standards for health insurance, determine the type and duration and scope of services
for health insurance, set the rates of payments and administer the program.

As part of the plan, the state must offer medical assistance for certain basic services to those
living under the poverty level. For adults over the age of 21, the states are not required to provide speechlanguage pathology and audiology services.