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Does Medicare Cover Home Health Care for Speech Therapy?
Date Updated: December 13, 2024
Written by:
Lauren Thomas is a seasoned writer that specializes in long-term care, with a special focus on dementia-related topics. She holds a degree in counseling and uses her knowledge and experience to create insightful content that gives seniors and families the information they need to make important care decisions.
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Dr. Brindusa Vanta is a health care professional, researcher, and an experienced medical writer (2000+ articles published online and several medical ebooks). She received her MD degree from “Iuliu Hatieganu” University of Medicine, Romania, and her HD diploma from OCHM – Toronto, Canada.
Yes, Medicare covers home health care for speech therapy, but beneficiaries still have out-of-pocket costs related to this treatment. You can qualify for speech therapy at home if you carry Medicare Part B coverage and your doctor certifies your need for services.
Who Qualifies for Speech Therapy Through Medicare?
You may be eligible for speech therapy through Medicare if:
- You have Part B coverage
- Your health care provider deems outpatient speech therapy medically necessary for you
- You receive services from a provider who accepts Medicare
- Your health care provider or therapist provides a written plan of care before the start of treatment
- The plan of care undergoes changes and updates as needed
How Much Will Medicare Pay for Speech Therapy?
For Medicare to pay for speech therapy, you must first meet your Part B deductible. In 2024, this amount comes in at $240 per calendar year. Once you’ve paid your deductible, Medicare covers 80% of the cost of the Medicare-approved fee.
To ensure you understand how much you can expect to pay for speech therapy, talk to your doctor or health care provider. Several factors influence the fee you pay, including other insurance coverage you carry, how much the home health care provider charges for services and where you receive services.
How Long Does Medicare Cover Home Health Care for Speech Therapy?
Medicare has no limits on how long it pays for medically necessary outpatient speech therapy services. This means you receive services as long as your health care provider considers them reasonable and necessary. However, your doctor may recommend you get services more often than Medicare covers them. Once your therapy provider no longer deems therapy services medically necessary but still recommends them, they must give you written notice before providing services. If you decide to continue receiving speech therapy services, you must cover all out-of-pocket costs related to services.