Does Medicare Cover Speech Therapy?

Let’s face it, it’s not fun getting older. Body parts give in to gravity, reflexes and movements get slower, and our vision and hearing weaken. As if that wasn’t enough, stroke risk increases with age and the older you get the more likely you are to develop dementia. While stroke and dementia are 2 conditions that are very complicated, they do have one thing in common: speech and language are affected. The range to which speech is affected varies from case to case but help is available. Luckily there are professionals called Speech-Language Pathologists (SLPs) trained to assess and treat many types of communication and swallowing problems including ones stemming from stroke or dementia and in many instances are covered under Medicare.

seniors toasting
Speech-language pathologists assess, diagnose, treat, and help to prevent communication and swallowing disorders in children and adults.

First let’s discuss two of the more common reasons you are likely to need speech therapy, having dementia and having a stroke.

Stroke

brain xray
A stroke is a life-threatening medical emergency where an individual experiences brain damage caused by a lack of blood supply to parts of the brain.

A stroke is one of the most common reasons adults receive speech therapy. The left hemisphere of the brain houses the language center. If you have a left hemisphere stroke or brain injury, aphasia often occurs. Aphasia is the loss of ability to understand or express speech, caused by brain damage. Meeting with a Speech-Language Pathologist will get you a formal diagnosis as to whether you have aphasia or no. They will set up with a treatment plan to get you on the road to recovery. Post stroke rehabilitation is possible and a Speech-Language Pathologist is an integral part of recovery.

Dementia

Another common reason older adults receive speech therapy is because they suffer from dementia. Dementia is a condition that causes memory loss and other thinking problems that worsen over time. Once diagnosed, the goal of any treatment is to maintain the patients quality of life for as long as possible. This is where a Speech-Language Pathologist is beneficial. A SLP can work on attention, memory, problem-solving, and higher-level thinking skills.

What’s Covered?

Medicare will cover speech therapy services when you meet specific requirements. Speech therapy can improve social communication skills, thinking, and understanding, and even things like swallowing. Doctors may recommend speech-language therapy to patients suffering from a head injury, brain tumor, stroke, or dementia. For Part B to cover speech therapy, your doctor must certify that it’s medically necessary and have a treatment plan ready. Medicare will cover 80% of the cost. You’ll be responsible for the remaining 20% unless you have a Medicare Supplement Plan to cover the rest. 

seniors talkingIf you or a loved one find yourself in need of speech therapy services, having the right insurance coverage is vital. If there are costs not covered by Medicare, you may find that having a Medicare supplement plan can save you a lot of money and stress,. To find affordable plan options  with the coverage you need contact EZ.Insure. To speak directly to a licensed agent call 888-753-7207 or enter your zip code in the bar on the side.

“Loss Of Language, Not Intellect”: Aphasia After A Stroke

A stroke can be horrifying, leaving the person with various challenges to overcome afterward. Aphasia is one of these challenges, caused by damage to the brain. It affects about 2 million Americans and occurs more in older adults than younger adults. Even though so many people in America have this disorder, more have never heard of it. This is why June is listed as National Aphasia Awareness Month, hoping to educate more people about it. Just because a person has this communication disorder does not mean they are less intelligent. They just have a hard time communicating. It is like when you have a word on the tip of your tongue, and you can not remember the word. There are different types of aphasia, from mild to severe, but with consistent speech therapy, a person has the chance of recovering fully.

What Is Aphasia?

Brain with microchip in the middle connecting circuits throughout the brain.
Aphasia often occurs after a stroke. It is caused by damage to the left side of the brain.

Aphasia is a communication disorder that affects a person’s ability to speak, read, write, and listen. It does not affect intelligence and is not a mental illness. It happens when there is damage specifically to the left side of the brain. The damage can be caused by a stroke or traumatic impact. People with the disorder experience it differently, dependant on what part of the brain is injured.

What Causes Aphasia?

Aphasia is usually a direct result of a stroke. About 25-40% of stroke survivors will develop aphasia. When a clot blocks a vessel in the brain, a stroke occurs. If a vessel ruptures, then hemorrhaging occurs. If blood is exposed to the brain, then it will become damaged. Why? Blood is actually poisonous to the brain. Other factors that cause aphasia are brain tumors, infections, head trauma, dementia, and Alzheimer’s.

The Types of Aphasia

People experience aphasia differently. It can be mild, or severe, and depends on what aphasia type they have after a stroke. The four different kinds are:

    1. Expressive (Broca’s) Aphasia– Injury to the frontal regions of the left side of the brain. The individual has a hard time forming complete sentences. The person knows what they want to say, but can not say the correct word or sentence. They tend to leave out words like “is” or “the.”  They understand the things they’re hearing or reading, but can not respond properly.
    1. Receptive (Wernicke’s) Aphasia– The individual has trouble understanding what is being said. For the individual, it is like being in a room where everyone is talking a different language, and they understand a few of the words. They say words that do not make sense or string them together meaninglessly.
    1. Global Aphasia– This is the most severe due to the damage done to the front and back regions of the left brain. It is a more widespread impairment. The individual loses almost all language function and has both a hard time understanding and forming sentences. They can not speak or understand what people are saying, nor can they read or write.
  1. Anomic Aphasia– This is the least severe form of aphasia. The individual will have difficulty using the correct name for people, places, or objects.
Caucasian sitting down with their hands on their lap, sitting in a circle with others blurred in the background.
Group therapy is used as a form of treatment for aphasia.

Recovery & Treatment

Aphasia is not always permanent, and some people can completely recover. This depends solely on a few factors that play a role in a successful recovery. These are the cause and severity of the brain damage, where exactly the brain damage is, and the age and health of the person. If symptoms last longer than 2-3 months after a stroke, a complete recovery is not likely. However, there are several treatment approaches to help a person improve over time. It is a slow, long process, but it will improve symptoms.

There are a variety of speech therapy exercises and techniques for stroke survivors with aphasia. They include:

    • Cognitive linguistic therapy which helps the person practice comprehension skills while interpreting the emotional components of language.
    • Programmed stimulation uses pictures and music.
    • Art therapy
    • Stimulation-facilitation therapy focuses on auditory stimulation.
    • PACE therapy uses drawing, pictures, and other visuals to help the individual generate ideas to be communicated.
  • Group therapy allows the individual to work together and more openly with those dealing with the same issues.

In order for therapy to be successful, there must be support from family and friends. It can be frustrating for all involved. The important thing is to

Yellow square note with "yes or no?"written in the middle of it.
Family and friends should ask yes or no questions to make communication easier.

remain calm. Family and friends should ask yes/no questions, write things down one word at a time, talk one idea at a time, and use gestures/props to communicate easier. It will take some time, but it will be beneficial for everyone, especially those with aphasia slowly working towards recovery. Remember, a person with aphasia did not lose their intelligence, just their ability to communicate it.