Health Insurance for Speech Pathology

Does Health Insurance cover speech pathology?

Private speech pathology is covered under many health fund plans. Check with your health insurance to see if your specific level of cover entitles you to a rebate. In Talkshop, we will provide you with the necessary information on the receipts for you to claim from your private health insurance. These item numbers below will be on your receipts if you have cover depending on the type of service rendered:

310 Speech Pathology Assessment for 45 minutes or less
320 Standard Speech Pathology Assessment (46 to 90 minutes)
330 Comprehensive Speech Pathology Assessment (2 hours)
340 Individual Regular Therapy Session (45 minutes or less)
350 Individual Regular Therapy Session (46 minutes to 90 minutes)
360 Individual Regular Therapy Session over 90 minutes
370 Group Treatment (45 minutes or less)
380 Group Treatment (46 minutes to 90 minutes)
390 Group Treatment over 90 minutes

Useful link: Rebates and Funded Programs

If you wish to add speech pathology to your cover, this can take up to eight weeks to come into effect. In the meantime, you may be eligible for a Medicare rebate for five sessions with a GP Chronic Disease Management Plan (CDM).

Here are some additional things to keep in mind when claiming speech pathology service rebates:

  1. You must have a valid private health insurance policy that covers speech pathology services.
  2. You must have received the service from a registered speech pathologist.
  3. The service must be a Medicare-eligible service.
  4. You may have to pay a gap amount, which is the difference between the cost of the service and the amount of the rebate.
  5. If you have any questions about claiming speech pathology service rebates, you should contact your private health fund.

Here are some additional tips for claiming speech pathology service rebates:

  1. Get a quote from the speech pathologist before you start treatment. This will help you to budget for the cost of the services.
  2. Ask the speech pathologist if they are registered with your private health fund. This will ensure that you can claim a rebate for the services.
  3. Keep a copy of all receipts and invoices for the services. You will need these to claim your rebate.
  4. Claim your rebate as soon as possible after the service is provided. This will help to avoid any delays in processing your claim.

My health fund has asked for all Medicare numbers to be removed

We issue all receipts with Medicare and health fund codes to allow clients to make claims wherever they need to.

Bupa and Teachers Health require special amendments to their receipts to allow them to be claimed. If your health fund is with either of these, please let us know so your receipts can be specifically amended.

My health fund says you’re not registered?

All speech pathologists at Talkshop Speech Pathology are registered as providers for health fund rebates with Australian health funds. We make every effort to register with all health funds. However, on occasion, a new health fund will start or merge, or their registration requirements may change without our knowledge. If you do find that we aren’t registered with your specific fund, please contact us. It usually only takes a phone call for us to register with them allowing you to access the rebate according to your health cover.

Here are some useful information regarding some private health insurance: