How to advocate for speech therapy services

When communication becomes difficult — whether from a stroke, brain injury, Parkinson’s, autism, developmental delay, or another condition — speech therapy can make a life-changing difference. Yet many people struggle to get enough therapy or don’t know how to ask for more.

That’s why advocacy matters. By learning how to navigate the system, ask the right questions, and gather the right information, you can improve your chances of getting the speech therapy you or your loved one needs.

In this post, we’ll share practical steps to advocate for speech therapy services, what to ask your doctor and speech-language pathologist (SLP), where to find therapy, and key differences between pediatric and adult advocacy.

Is speech therapy covered by insurance?

One of the first questions families often ask is: “Is speech therapy covered by insurance?” The answer is: it depends.

Coverage varies widely depending on:

• Your insurance plan (ex: Medicare, Medicaid, private, VA, etc…)
• The diagnosis and medical reason for therapy
• The setting (hospital, inpatient or outpatient rehab, school, private clinic, teletherapy, or home health)

Because policies vary, it’s important to call your insurance company directly to get an understanding of your coverage. Use the term “speech-language pathology” or “speech therapy” when asking. Request written documentation about what is covered, how many sessions are allowed, if there are any copays, and whether you need prior authorization.

Tip: Ask your SLP or doctor’s office for help navigating the process — they often know how to word requests to meet insurance requirements.

Steps for getting speech therapy

Here are some practical steps you can take to advocate for speech therapy services:

1. Check Insurance Coverage (Primary & Secondary, if applicable)
Before you begin requesting referrals or gathering medical records, it’s helpful to understand what your insurance covers.
Call your insurance company and ask:

• Is speech therapy covered under my plan? Are there any copays?
• Do I need a referral from my primary doctor?
• Are there session limits per year?
• Is a specific diagnosis required for coverage? / Is (insert your diagnosis) covered by speech therapy?
• Do I need prior authorization before starting therapy?
• Which speech therapy providers are in-network?
• If I see an out-of-network provider for speech therapy, will you accept Superbills for reimbursement? (A superbill is not a bill from insurance, but rather a detailed receipt of services from your out-of-network therapist, that you can submit to your insurance company for potential reimbursement.)

2. Gather Documentation & Evidence

• Ask your primary care provider (PCP) or specialist (ex: neurologist, cardiologist) for a written referral or prescription for speech therapy.
• Collect medical records, hospital notes, and test results that show why therapy is needed.
• If you’ve already had a speech-language evaluation or participated in prior sessions, keep a copy of the written report and therapy notes.
• Track symptoms and changes in speech, language, voice, swallowing, or cognition – that are impacting daily life and participation in tasks.

3. Communicate with Providers
Ask clear, direct questions when meeting with your PCP or SLP (speech-language pathologist):

PCP

• Can you provide a referral for speech therapy?
• Can you document medical necessity for ongoing speech therapy?
• What are my options for therapy settings (outpatient, home health, telehealth)?
• Will you or someone in your office be available to reach my speech therapist via fax, phone, or email?

SLP

• What are my speech therapy goals?
• How many sessions are recommended?
• What progress should we expect?
• Can you provide documentation or recommendations to support additional therapy?
• Are there exercises, community programs, support groups, or technology that can help me practice outside of therapy?
• If I’d like to continue working on my skills, what is the plan after I am discharged from your speech therapy services?”

Pediatric vs. adult speech therapy: What to know

Advocating for speech therapy looks a little different depending on age:
 For Children & Teens

• Ask about coverage for your specific diagnosis, such as developmental delays, autism spectrum disorder, or speech-sound disorders.
• Children may receive services through early intervention programs (birth–3), school districts (ages 3–21), outpatient rehab, or private clinics (insurance or cash-pay).
• Schools may provide speech therapy under an Individualized Education Program (IEP).
• If the school provides limited therapy, families can pursue private therapy.
• Pediatricians can be strong allies — request that they document milestones and delays clearly.

For Adults

• Adults often qualify for speech therapy after a stroke, brain injury, Parkinson’s, or other neurological condition.
• Therapy may be offered in hospitals, skilled nursing facilities, outpatient clinics, or at home (in-person or teletherapy).
• Insurance may limit therapy sessions if progress slows, even though ongoing therapy could still help. Call your insurer to appeal the decision and clarify what information they need for reconsideration.
• Explore state-based programs or nonprofit organizations that may help cover therapy costs.

Bonus Tip: If access is a barrier, both pediatrics and adults can get speech therapy virtually, from any therapist licensed in their state. Check your insurance for coverage! If finances are a barrier to receiving therapy, SLP graduate programs and nonprofit organizations may offer free or reduced cost speech therapy services to both pediatrics and adults.

Where to find a speech therapist

If you’re looking for speech therapy, here are some places to start:

• Doctor referral: Ask your PCP or other provider for recommendations and a referral.
• Hospitals and rehab centers: Many offer outpatient therapy programs.
• Schools: For children, services may be available through the school district.
• Private practices: Search for local speech therapy clinics in your area for in person therapy, or speech therapists licensed in your state for virtual therapy.
• Professional directories: Use the American Speech-Language-Hearing Association (ASHA) “Find a Professional” tool.
• AAC providers and support organizations: Companies like Lingraphica and nonprofit organizations often connect families to resources.
• Looking for Lingraphica AAC expertise? Start with our curated list of SLPs certified in Lingraphica devices — they’re trained to guide you through AAC trials, device use, and ongoing support.

Final thoughts

Advocating for speech therapy takes persistence — but it’s worth it. Start by asking the right questions, requesting clear documentation, and exploring multiple therapy settings. Whether for a child or an adult, communication is too important to leave unsupported.

If you or a loved one needs help communicating, don’t give up after the first discharge from therapy. With the right knowledge and resources, you can ensure that speech therapy remains a priority in your communication recovery journey.