How to Use Insurance for Speech Therapy and OT
Written and reviewed by Rachel Yashouafar, MA, OTR/L. Last reviewed October 14, 2026.
You found a therapist you like, or your pediatrician handed you a name. Then comes the question you have been dreading. Can I use insurance for speech therapy or OT here?
Families use insurance for speech therapy and occupational therapy at Therapy Clubhouse through Village, a company that holds the plan contracts and handles the billing. A child is seen by Therapy Clubhouse therapists. What a family owes is set by their own plan, and it is confirmed before the first visit.
No diagnosis or referral is needed to ask.
How do I use insurance for speech therapy here?
You use it through Village. Your child sees our speech or occupational therapist, and Village takes care of the insurance side, so you never get a bill from us.
It runs in four steps. First, a free 15-minute call where you tell us what you are noticing. Second, your coverage is checked, and you are told what your family would pay before you commit to anything. Third, the evaluation with our therapist. Fourth, therapy begins. You work with us on your child’s goals, and Village handles the billing.
Who is Village, and why is a second company involved?
Village is a company that holds contracts with insurance plans and handles billing for pediatric therapy. It is not your insurance company. You keep the plan you already have.
We are not in network with plans directly yet. We are working toward our own credentialing, and until that is finished, Village is how insurance works with us. Village holds the contracts and bills your plan. Your child is still seen by our therapists, and Therapy Clubhouse is still led by Nita Anavim, M.S., CCC-SLP, and Rachel Yashouafar, MA, OTR/L.
Does insurance have to cover speech and OT for children?
Many plans do, but not all of them, so what your own plan says is what counts. Federal rules put children’s therapy in a group called habilitative services.
The rule tells plans to cover care that helps “a person keep, learn, or improve skills and functioning for daily living,” and it is unusually plain about who that means. The federal essential health benefits rule says: “Examples include therapy for a child who is not walking or talking at the expected age.”
Large employer plans and some older plans sit outside that rule, which is why we check your real coverage instead of guessing from the plan name. You are also far from the only family asking. The National Institute on Deafness and Other Communication Disorders reports that more than half, 59.7%, of U.S. children ages 3 to 17 who have a voice, speech, or language disorder received intervention services in the past year.
Which plans can I use, and what will I pay?
Through Village we can currently work with Blue Shield of California, UnitedHealthcare, Anthem Blue Cross Blue Shield, Cigna Healthcare, Aetna and TRICARE. For the five commercial plans on that list, Village accepts PPO plans only.
What you owe depends on your own plan. It can include a copay, coinsurance, a deductible or other patient responsibility, and you pay it to Village, not to us. Village also charges a fee of its own for each visit, called a Non-Covered Service Fee, on top of your plan’s share. You will see that name on your paperwork, and we would rather you hear it from us now than meet it on a statement later. Your coverage is checked through Village first, so you know your number before you commit.
What should I ask when I call my insurance plan?
Call the member number on the back of your card and write down the reference number for the call. A handful of questions decide most of what you pay.
Ask whether the plan covers outpatient speech-language pathology and occupational therapy for a child. Ask whether it covers habilitative services as well as rehabilitative ones, because some plans cover only the second kind. Ask if there is a visit limit each year, and whether speech and OT share one combined limit. Ask whether a doctor’s referral or prior authorization is required before an evaluation. Ask what the deductible is and how much of it the family has already met this year. Ask whether a diagnosis is required for coverage. Plans answer these differently, and the answers change what your first month looks like.
What if my plan is not listed, or I would rather not use insurance?
You still have options, and it is worth a call either way. The list above is what we can work with today, and plans change.
Private pay is available, and we give you a superbill to send to your plan for possible out of network reimbursement. Children under 3 who qualify may receive no-cost Early Start services through Tri-Counties Regional Center. If you would rather picture the first visit before you think about any of this, read what to expect at a speech evaluation or what happens at an OT evaluation. We see children at home and by telehealth today, and our post on choosing between in-home and clinic therapy can help you picture the difference.
Asking what this will cost is not a small question, and it is not an awkward one. It is part of taking care of your child, and you deserve a straight answer before you begin rather than after. Let’s talk about it.
Ready to take the next step? Call (805) 702-3427 or schedule a free 15-minute consultation with a licensed pediatric therapist.
Therapy Clubhouse provides in-home and telehealth services today; our Westlake Village clinic opens December 1, 2026.
Common question: What insurance plans do you accept?
Rachel Yashouafar is a registered and licensed occupational therapist (MA, OTR/L) and co-founder of Therapy Clubhouse who helps children from birth to 18 develop motor, sensory, and everyday-living skills through play-based, family-included therapy.
This article is for general educational purposes only and is not medical advice or a substitute for an individualized evaluation. Every child is different. If you have concerns about your child’s speech, language, or development, please consult a qualified professional.
Start with a free consultation
Connect with our team to learn what support is right for your child and what the next step looks like.
