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question

Anonymous
Posted by Anonymous
  • 8 Replies

hi we live here at camp pendleton my daughter teacher said she need speech and yes she can take it at the school but school will be getting out soon. she told me about some speech therapist out in town so my question do i need to get a referral from her doctor in order for tricare to pay for it her teacher said i didn't but i want to make sure.

Posted by Anonymous on May. 9, 2014 at 12:27 PM
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Replies (1-8):
Anonymous
by Anonymous on May. 9, 2014 at 12:35 PM

I know when my son had to go to speech therapy I had to get an referral from my doctor. Even when I was back in California I had to see my doctor to get an referral. Not sure if you go to the actually hospital, but it took a civilian doctor to catch his delay speech. I used beach kids therapy. They are the best! My son is now 6 years old and he never stops talking and that's because they worked with him individually and group play. You always need a referral regardless because you never know if tricare can cover it. Hope this helped!

Anonymous
by Anonymous - Original Poster on May. 9, 2014 at 12:37 PM

 

Quoting Anonymous:

I know when my son had to go to speech therapy I had to get an referral from my doctor. Even when I was back in California I had to see my doctor to get an referral. Not sure if you go to the actually hospital, but it took a civilian doctor to catch his delay speech. I used beach kids therapy. They are the best! My son is now 6 years old and he never stops talking and that's because they worked with him individually and group play. You always need a referral regardless because you never know if tricare can cover it. Hope this helped!

 thanks

.oOMellyOo.
by Silver Member on May. 9, 2014 at 12:42 PM
1 mom liked this

Your childs PCM will have to write a refferal. Once you see the speeth pathologist they will determine what the "cause" is and Tricare may or may not pay for services.

Speech Therapy

TRICARE covers speech therapy when prescribed and provided or supervised by a physician to treat speech, language and voice dysfunctions resulting from birth defects, disease, injury, hearing loss and pervasive developmental disorders.

TRICARE does not cover services for:

  • Disorders resulting from occupational or educational deficits
  • Myofunctional or tongue thrust therapy
  • Videofluroscopy evaluation
  • Maintenance therapy that does not require a skilled level after a therapy program has been designed
  • Special education services from a public educational agency to beneficiaries age 3-21
chrlstoncharmed
by Melissa on May. 9, 2014 at 1:20 PM
1 mom liked this

I couldn't get a referral until I submitted my daughter's IEP from the school. 

jas_momof2
by アニメの雌犬 on May. 9, 2014 at 4:09 PM

We went the other way (it started with the PCM then to the school) but for those whose schools identify the problem, you should bring that to the PCM.

Quoting chrlstoncharmed:

I couldn't get a referral until I submitted my daughter's IEP from the school. 



SlapItHigh
by Gold Member on May. 10, 2014 at 1:17 AM

I would think you'd need a referal.

darbyakeep45
by Darby on May. 10, 2014 at 7:01 AM

Same here.  My son started his therapies before he was in school.  His doctor did tell me that Tricare will only cover speech therapy for a child IF the child needs more than the school will provide.  Then the PCM will put in a referral.  My son's doctor has always put in referrals with no problem.  

Quoting jas_momof2:

We went the other way (it started with the PCM then to the school) but for those whose schools identify the problem, you should bring that to the PCM.

Quoting chrlstoncharmed:

I couldn't get a referral until I submitted my daughter's IEP from the school. 


KateHorrell
by Member on May. 11, 2014 at 12:22 PM

Us, too.  We took her teacher's recommendation to her PCM who sent us to the military's speech-pathologist.  We took the speech pathologist's report to the school's special education services, who then wrote her an IEP to get services via the school (even in the summer.)

Quoting jas_momof2:

We went the other way (it started with the PCM then to the school) but for those whose schools identify the problem, you should bring that to the PCM.

Quoting chrlstoncharmed:

I couldn't get a referral until I submitted my daughter's IEP from the school. 


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