It can be a scary and confusing time when you or a loved one is dealing with a chronic illness such as stroke, brain injury, Multiple Sclerosis, Parkinson’s disease, or Alzheimer’s disease.
The lack of publicly funded rehabilitation for the difficulties that come along with these illnesses can leave families feeling desperate and wondering who will help foot the bill for the therapies they or their loved ones need to recover.
In a cruel twist of fate, these illnesses often occur at a time in life when people are now needing to live on reduced income (e.g. retired and on pensions).
Take a closer look at your extended health benefits
Although most people know that services like physiotherapy and massage therapy are covered by the extended health benefits provided by their insurer, they often don’t realize that these benefits often include coverage that can help pay for speech therapy as well.
Typically this coverage is listed under the Medical Rehabilitation section of your policy. It may include a lump sum per calendar year (e.g. coverage up to $500 per calendar year) or a maximum amount covered per therapy session (e.g. coverage up to $100 per session).
If it’s unclear what is covered in your policy, a quick call to your insurer can answer many of your questions.
Think outside the box
Many insurance policies offer a maximum amount covered per year per claimant. This means that you and your spouse could BOTH be entitled to that amount of coverage.
Speech therapy sessions for you or your spouse can often include a component of caregiver/spouse training. This is where the speech therapist teaches you how to target the skill area so that you can practice with your partner at home in order to help carryover the skills learned in the therapy session.
What this means is that, if your case fits the criteria, part of the session can be billed/claimed for your spouse/caregiver and part of the session can be billed/claimed for you – extending the amount of coverage you can access to help pay for speech therapy
Stick it to “the man”
Just because the government doesn’t always fund these health services through OHIP doesn’t mean that you can’t get some assistance from the government to help pay for speech therapy
If you are receiving speech therapy for a chronic medical condition (e.g. brain injury, stroke, multiple sclerosis, etc.), you may be eligible for a Disability Tax Credit.
Visit the CRA website at http://www.cra-arc.gc.ca/tx/ndvdls/tpcs/ncm-tx/rtrn/cmpltng/ddctns/lns300-350/316/pply-eng.html for more information on eligibility and how to apply.
Take Advantage of Assistants
Communicative Disorders Assistants (CDAs) can work under the direction of a speech therapist to provide treatment to you or your loved one and are a lower cost alternative to treatment with a speech therapist.
However, CDA services are not appropriate for all clients and candidacy for these services is determined by a Speech-Language Pathologist. A speech therapist would still need to complete sessions with you or your loved one at regular intervals to monitor progress and make recommendations.
Consider Creative Alternatives to Help Pay for Speech Therapy
Although nothing can replace the benefits you or your loved one would receive from one-to-one treatment with a speech therapist, there are other alternatives to receive some level of help.
Group therapy, such as our brain injury groups, where people working on similar difficulties can receive therapy together, is one option to consider as the cost of a session could be shared with the other individual(s). Support-Focused groups can also be a more affordable alternative, such as the supported communication group offered by our clinic for adults with brain based communication impairments (e.g. stroke, dysarthria, brain injury, etc.).
Again, the caveat here is that there is less “treatment” going on in these larger group scenarios, so the gains made by you or your loved one will not be as great as if receiving individual therapy. That being noted, there is much to be said about the benefit of practicing communication skills with others in more natural contexts!
Although it may be frustrating to consider the lack of OHIP funded therapy, no matter what your situation, there is often a creative solution to help you provide for you or your loved one’s needs!
Melissa Kiley is a registered Speech-Language Pathologist with a special interest in concussion/acquired brain injury as well as literacy skills development. She has been working with clients for over 10 years and is highly skilled in developing functional and innovative treatments.