Speech Therapy Coverage with Cigna in California
At Verse Therapy, we understand how important speech therapy is for individuals of all ages. If you have Cigna insurance, you likely have coverage for speech therapy services that can help improve communication abilities. Below, we break down how Cigna's coverage works and how you can easily access the care you need.
Find In-Network ProvidersMeet Our Licensed Therapists In-Network with Cigna in California
Cigna's Speech Therapy Coverage
Cigna provides coverage for speech therapy when it is considered medically necessary. This typically means:
- A doctor has determined that speech therapy can help you make meaningful progress.
- Therapy is expected to bring noticeable improvement within a reasonable time.
- Services are provided by a licensed speech-language pathologist.
- Treatment follows a written plan of care approved by your physician.
Common Conditions Covered
Cigna covers speech therapy for a variety of conditions, including:
- Speech and language disorders, such as expressive and receptive language delays
- Swallowing and feeding difficulties for children and adults
- Voice disorders related to anatomical or neurological conditions, injury, or surgery
- Speech and language difficulties due to stroke, injury, or neurological diseases
- Hearing impairment as a result of trauma, tumor, or disease
Some Conditions May Not Be Covered
Cigna may indicate that some therapy is not medically necessary, including for the following conditions:
- Food aversions
- Functional dysphonia, spasmodic dysphonia, or chronic cough
- Professional or recreational communication
Other Important Coverage Limitations
- Some plans may limit therapy to a certain number of visits per year.
- Some plans may require a physician’s referral or prior authorization to cover care.
- Therapy focused on maintaining current skills (rather than improving them) may not be covered.
- Therapy for speech patterns that typically resolve on their own, such as natural speech dysfluency in young children, may not be covered.
How Verse Helps You Get Started
Getting started with speech therapy can feel overwhelming, but you don’t have to navigate it alone. At Verse Therapy, we’re here to help you through each step and make the process as seamless as possible.
How We Support You:
- We Verify Your Benefits – We’ll check your Cigna coverage for speech therapy services and explain what’s included in your plan.
- We Handle Referrals & Authorizations – If your plan requires a physician’s referral or prior authorization, we’ll help coordinate with your doctor and Cigna to get the approvals needed.
- We Match You with the Right Provider – Our team will connect you with a licensed speech therapist who fits your needs and is in-network with Cigna.
- We Schedule Your First Appointment – Once everything is in place, we’ll help you book your initial evaluation and get started on your therapy journey with ease.
Understanding How Cigna Insurance Works
Navigating insurance can be confusing, so here’s a quick breakdown of key terms to help you understand how they may impact your care at Verse.
- In-Network vs. Out-of-Network: When a provider is in-network with Cigna, they are under contract with Cigna to provide discounted services to its members. If a provider is out-of-network with Cigna, Cigna may still cover some costs for services, but you may be responsible for more.
- Copay: This is the fixed amount you pay for each visit. If your copay for speech therapy is $30, for example, you pay that amount for each session, and Cigna covers the rest.
- Deductible: This is the amount you must pay out of pocket before Cigna starts covering costs. If your deductible is $500, for example, you’ll need to pay that amount for medical services (including those outside of Verse!) before your insurance starts contributing.
- Coinsurance: After meeting your deductible, you may still be responsible for a percentage of the cost. For example, if your coinsurance is 20%, Cigna will cover 80% of the cost of therapy, and you will owe the remaining 20%.
- Out-of-Pocket Maximum: This is the most you’ll have to pay for covered medical services in a plan year. Once you reach this limit, Cigna will cover 100% of approved services.
Success Stories with Cigna & Verse Therapy
FAQs about Cigna
If you provide your insurance information, Verse will get in touch with {{insurance}} to verify your coverage and break down your benefits to you. We’ll let you know if your plan includes speech therapy services.
Depending on your plan, there may be deductibles, co-pays, or coinsurance that you will be responsible for. Verse will check this for you and provide you an estimate of your out-of-pocket costs before you begin therapy.
Not all {{insurance}} plans require a referral from a doctor and/or prior authorization before therapy begins. If yours does, we’re happy to help you coordinate with your doctor and with {{insurance}} to get this approval.
If we are out-of-network with your {{insurance}} plan, you may still have options. Some plans actually offer coverage for out-of-network providers. We can help you understand your benefits, provide necessary documentation for reimbursement, and explore other solutions to make speech therapy accessible for you.