Getting Your Employer to Cover Speech, Language, and Hearing Services

A Checklist for Speech-Language Pathologists and Audiologists

Speech-language pathologists and audiologists should be sure their own health plans offer speech, language, and hearing benefits, and be prepared to advocate for improved coverage when needed. While many health plans and managed care organizations recognize the importance of speech, language, and hearing services, there are still a number of plans that do not cover these services or offer only limited coverage. Health plans that offer comprehensive coverage packages address the overall wellness of plan participants, which keeps health costs down. Here is a "checklist" that will assist you in approaching your employer for coverage of services. You may need to make modifications to fit your advocacy effort.

Review Your Employee Health Plan Benefits

• Review your employee health plan benefits to determine coverage of speech, language, and hearing services. What is covered? What are limits? Could benefits be better?
• Use the brochure, Making Sense of your Health Insurance Plan [PDF], to help your evaluation.

Identify the Person You Should Talk to

• Target the person within your organization who makes decisions about employee health benefits. It might be the human resources director, benefits specialist, union representative, or company president.

Schedule a Meeting

• Set up a meeting to introduce yourself, and to discuss speech-language and audiology services as covered benefits in an employer-sponsored health plan. Explain that these services are essential components of a basic benefit package. Provide a copy of ASHA's Scope of Practice for both Audiology and Speech-Language Pathology and a descriptive ASHA brochure about coverage of services.

Topics to Discuss at the Meeting

• Discuss the importance of communication. It affects every aspect of a person's life, including family and work interactions. Evaluation and treatment of a hearing loss or other communication disorder can improve an employee's performance on the job and improve employee moral and productivity.
• Explain who speech-language pathologists and audiologists are and what they do. Briefly discuss education and license requirements and typical practice settings, including hospitals, clinics, and private practice. 
• Promote coverage for speech, language, swallowing, audiologic evaluations, aural/audiologic rehabilitation, and treatment related to illness, disease, injury, congenital and/or developmental conditions. Provide ASHA's model benefit language.
• Promote coverage for hearing aid assessment, fitting, orientation, and hearing aids. Undetected and untreated hearing loss in young children impairs speech-language skills, learning ability, and social growth. In adults, it can cause depression, social isolation, and lowers worker productivity.
• Promote coverage for augmentative/alternative communication, communication assessment, and related assistive devices. People who are nonspeaking use such devices to communicate their needs at work, home, and in the community.
• Tell the employer that speech, language, and hearing benefits are a must if a health plan is to provide comprehensive health care benefit, and that such benefits allow employees to communicate effectively at work and at home.
• Some employers may ask why such services should be covered in the company health plan when these services are provided by the public schools. Explain that schools treat communication disorders that impact education and learning. Clinics, hospitals, health departments, and private practices provide speech-language pathology and audiology services beyond what may be available in public schools.

Use Statistics to Support Your Argument

• Your employer will want to know the percent of the employee population that needs speech, language, and hearing coverage and how many would be expected to use the benefit. Explain that 1 out of 6 Americans has a communication disorder.
• Share data on other companies in your region that currently provides these services. Call colleagues, friends, and family to determine such coverage. An ASHA survey showed 82% of Fortune 500 companies cover speech-language pathology and audiology services.
• Employee benefits professionals will want to know the cost benefit of your services. Adding these benefits to a health plan costs less than 35 cents per member per month. Costs to add the benefit are minimal, as is usage.
• Invite the employer to visit your clinic or treatment setting to observe the services being performed.
• An employer will want to know what is reasonable to cover and not to cover. Offer guidance from your own practice records. Provide a copy of ASHA's Prefered Practice Patterns for both Speech-Language Pathology and Audiology. Treatment efficacy data may also help an employer in designing a plan. For example, efficacy data shows that stuttering treatment results in improvement in 70% of all cases.

Follow-up

• Send a thank you note (written or e-mail). Thank him or her for considering the addition of these benefits.  
• Tell your co-workers about the importance of coverage for services and ask them to contact the person you met with to support this expansion of coverage.