Author(s)
Kevin B. Xiao, MD
Carlye B. Goldenberg, BS
Carson K. Gates, BS
Mark R. Gilbert, MD
Affiliation(s)
University of Missouri School of Medicine;
Abstract:
Background: Voice therapy is used to treat dysphonia from various causes. It is often the first-line treatment and used as an adjunct to medical or surgical management. Despite its documented efficacy, few patients with dysphonia seek treatment, including voice therapy. Insurance coverage can affect patients’ decisions and ability to pursue voice therapy. To date, no studies have investigated variations in insurance coverage of voice therapy for the treatment of dysphonia in the United States.
Methods: A cross-sectional study was performed to review insurance policies from the top three commercial insurers by enrollment percentage and Medicaid in all fifty states in the United States. The top three commercial insurers were determined using publicly available 2021 data from the Kaiser Family Foundation. Insurance policies for each of the top three commercial insurers and Medicaid in all fifty states were then identified using an internet search. Coverage for voice therapy was categorized as covered, requiring pre-authorization, determined on a case-by-case basis, or not covered based on documented policies.
Results: Amongst 150 commercial insurers, 90% (n=135) provided coverage for voice therapy, 7.3% (n=11) required prior authorization, 2% (n=3) were determined on a case-by-case basis, and 0.67% (n=1) did not provide any coverage. 86% (n=47) of the top insurers in each state provided coverage for voice therapy. Medicaid covered voice therapy in 84% (n=42) states.
Conclusions: Variations in the coverage of voice therapy exist in the United States. Overall, the majority of top insurers in each state and Medicaid provide coverage for voice therapy for the treatment of dysphonia.