Private Insurance Question Re: coverage of PT, OT, ST

Since EI in New Jersey is not free I decided to explore having the services covered through our health insurance plan.

I was told that my policy specifically excludes services related to development or educational in nature. Is that normal?

Re: Private Insurance Question Re: coverage of PT, OT, ST

That's pretty much the norm unfortunately. But, hopefully that changes soon. I would be persistent though and ask under what circumstances is therapy covered. Speak to a supervisor. I have heard that people were successful in getting them to cover the therapies. Took a while, but there was success.

I'm trying to get private speech for the Summer for my son through my insurance since he doesn't qualify for an extended school year. I have been told that since he has a PDD diagnosis, that nothing would be covered since it's not something that can be "cured" eventually eliminating the need for therapy. I'm trying to get around that because he has developed a stuttering problem in the last six months that is unrelated to his diagnosis. So hopefully it will be covered.

Re: Private Insurance Question Re: coverage of PT, OT, ST

It is so unfortunate and unfair on how they view PDD and other developmental disorders. This really needs to change. I'll have to speak to the neurologist to see if he knows of a way to get around the exclusion.

Good luck in getting your son covered!!!

Re: Private Insurance Question Re: coverage of PT, OT, ST

We use our ins. for OT therapy. They don't cover that much, only 20 or 30 visits.