In our experience, we have observed that some – but not all – of New Zealand’s health insurance agencies will provide funding for private speech-language therapy services. So, if you would like your health insurer to pay for treatment, please check them before your initial assessment appointment to confirm that they are able to help. If your insurance policy will cover the cost of private speech-language therapy, it will be helpful if you ask them for a list of the information they would need in order to approve funding. As an example of what to expect, they are likely to at least require a description of symptoms, an estimation of the cost of treatment and an explanation of the medical necessity of treatment. Note that an initial assessment is typically necessary for Vocalsaints to gather the information required for insurers to approve payment. Any assessments, reports or therapy sessions which you choose to undergo before Vocalsaints receives payment from the insurer will need to be paid for in the normal manner, i.e. by the client or their caregiver themselves. Another option which some people prefer, is to pay only for an initial assessment, then just wait a few days for their insurance company to approve coverage of the remaining treatment costs.
In our experience working with previous clients, we have identified two ways by which Work and Income New Zealand may provide financial assistance to help cover the costs of private speech language therapy. One way WINZ may be able to help is by allocating funds directly to a client or their caregiver as a Disability Allowance. The other is by subsidising treatment costs with a Special Needs Grant. Below, we will discuss our understanding of these WINZ funding processes as relates to speech-language therapy – but please remember that it is always best to contact a WINZ staff member for authoritative, “first-hand” information. First, let’s look at the Disability Allowance. This can be made available for an individual to use at their own discretion, including for the purpose of receiving speech-language therapy. It is our understanding that this allowance is meant for adults or children who have a disability that is likely to last six months or more, and which causes them to require ongoing support to undertake the normal functions of life. Certain speech-language disorders meet this criteria, such as a severe and long-term stutter. You will need to contact WINZ to apply for the Disability Allowance, and a registered medical practitioner such as your family’s Doctor will need to endorse the application. If your disability involves a communication disorder, a Speech-Language Therapist will provide information to assist your Doctor’s diagnosis. As well as the Disability Allowance, WINZ may provide financial assistance to help children receive private speech-language therapy in the form of a Special Needs Grant. Going by our past experience, applications are reviewed on a case-by-case basis, with the following being important criteria for acceptance: 1. New Zealand Residence: The child must be a citizen or permanent resident of New Zealand. 2. Diagnosis: The child needs to have been diagnosed with a communication delay or disorder. This diagnosis may be provided either by a private Speech-Language Therapist, or a public practitioner on behalf of the Ministry of Education (MoE). 3. Ineligibility for Public Services: A MoE Speech-Language Therapist (or their representative) needs to have determined that the child is NOT eligible for support from public services. 4. Below Income Threshold: The income of the child’s family must be below a certain level, as decided by WINZ. Note that WINZ will NOT provide financial assistance if a child is on the waiting list for assessment or treatment by the Ministry of Education’s public speech-language therapy services; the child must have already been deemed ineligible for public support. For more advice and guidance when seeking WINZ funding, please take a look at the Work & Income website or contact your local WINZ branch. If you have queries about how you might receive financial assistance for speech-language therapy services, please also feel free to contact us
The Accident Compensation Corporation can assist you with the costs of speech-language therapy treatment in some circumstances. ACC will need to confirm that your need for speech therapy has arisen due to an accident, or due to complications with medical procedures after an accident. For example, if a person had an accident that involved a head injury and which caused them to have difficulties with word retrieval or speech clarity, ACC would be more likely to subsidise their speech therapy costs. Typically, we (or another qualified Speech-Language Therapist) would need to conduct an assessment to gather the information ACC needs to approve coverage. In Vocalsaints’ case, we normally ask for clients to pay for this initial assessment themselves, in case ACC do not approve funding. If ACC does approve coverage of speech-language therapy, they will then subsidise around 65% of the costs of each treatment session.