# Variability in Insurance Coverage for Adult Voice Therapy in The United States of America

## TL;DR

This study finds that while most US insurance plans cover voice therapy for voice disorders, coverage varies widely between insurers and Medicaid plans, potentially affecting patient access.

## Contribution

The study provides the first comprehensive analysis of voice therapy insurance coverage variability across major insurers and state Medicaid plans in the US.

## Key findings

- 88.2% of top commercial insurers cover voice therapy, but coverage details vary significantly.
- 76.5% of state Medicaid plans cover voice therapy, with notable differences in copays and visit limits.
- Commercial insurers allow significantly more annual voice therapy visits compared to Medicaid.

## Abstract

Voice therapy is often the first‐line treatment and an adjunct to medical or surgical management of dysphonia. However, a minority of patients with dysphonia utilize voice therapy. Insurance coverage can affect patients' decisions and ability to pursue voice therapy. The objective of this study was to investigate variability in insurance coverage of voice therapy for treatment of dysphonia in the United States of America.

A cross‐sectional study was performed to review insurance policies from the top three commercial insurers and Medicaid in all 50 states and District of Columbia (DC). Top three commercial insurers were determined using 2021 enrollment data. Policies for commercial insurers and Medicaid in all 50 states and DC were then identified using internet search. Voice therapy coverage was categorized as covered, requiring prior authorization, determined on case‐by‐case basis, or not covered. Copay and visit limitations were also assessed.

Among 153 commercial insurers, 135 (88.2%) provided coverage for voice therapy. 39 (76.5%) state Medicaid plans provided coverage for voice therapy. There was no association between coverage status and insurance type (p = 0.06). Commercial insurers (34.09 ± 13.8) were associated with significantly higher annual visits limit than Medicaid (23.8 ± 10.1) (p = 0.02). There was a significant association between commercial insurers and documented copays (p = 0.01).

While most of the commercial plans and Medicaid provide voice therapy coverage, discrepancies still exist, and many insurance providers do not provide coverage. This variability may contribute to disparities in access and outcomes for individuals with dysphonia.

N/A.

A cross‐sectional study was performed to review online health policy information related to the coverage of voice therapy among the three largest commercial health plans and Medicaid in each state and DC. Although most of the top commercial insurers and state Medicaid plans provided coverage for voice therapy, a large number still do not. Differences in annual visit limits and copays still exist as well among these insurance plans.