Getting speech therapy through TRICARE
By TRICARE Staff, TRICARE
/ Published January 03, 2017
Some children and adults have trouble saying certain sounds or words. Not only will speech and language disorders—such as articulation disorders, fluency disorders, voice disorders and language disorders—make it difficult to speak clearly, other conditions such as hearing impairments, cleft or lip palate, autism spectrum disorder or breathing and swallowing disorders could also affect one’s speech. If your child has a lisp, stutters, speaks in a mumbling or nasally way, or if they have a hard time putting words together to express their thoughts successfully, they may benefit from speech therapy.
Participating in speech therapy is a great way to learn to speak more clearly. TRICARE covers speech therapy to treat speech, language and voice dysfunctions resulting from birth defects, disease, injury, hearing loss and pervasive developmental disorders. You’ll need to have a referral or prescription to get speech therapy services. Contact your primary care manager if using TRICARE Prime or your family provider if using TRICARE Standard and Extra.
Speech therapy services are separate from any other services your child may be getting through the Extended Care Health Option, Autism Care Demonstration or any other special program. It requires a separate referral and authorization. If you get speech therapy without a referral, you may pay more out-of-pocket.
TRICARE doesn't cover speech therapy services for disorders resulting from occupational or educational deficits, myofunctional or tongue thrust therapy, videofluroscopy evaluation, maintenance therapy that doesn’t require a skilled level after a therapy program has been designed or special education services from a public educational agency to beneficiaries age 3-21. To learn more about TRICARE’s speech therapy benefit, please visit the TRICARE website.