Habilitative Questions to Ask

​Before you call your insurance company or HMO, please refer to the “Parents' Guide to H​abilitative Services" available on our website

  1. ​ My child needs physical therapy and/or occupational therapy and/or speech therapy. Are these services covered under my plan? 
  2. Do I have coverage for habilitative service benefits under my plan?
  3. Are there any limitations on habilitative services coverage under my plan? If so, what are they? 
  4. Are there any exclusions from coverage under my habilitative services benefit? If so what are they? 
  5. What cost-sharing will be applied to habilitative services for my child? 
    1. Deductible   
    2. Copayment amounts   
    3. Coinsurance
  6. Does my deductible apply to each calendar year or to a benefit year?  If it applies to a benefit year, when does the benefit year begin and end? 
  7. Do I need a referral? If so, how do I get one? 
  8. Do I need prior authorization? If so, how do I get prior authorization? 
  9. Do I have better benefits if I use in-network providers? If so, who are the in-network providers in my area? 
  10. I think I need more information; may I please speak with a supervisor? (as needed) ​​​