You could get more therapy from Insurance. Here's how.

You might be discharged while with benefits still available. Here's why.

One of the first questions I ask patients is "how many more sessions of speech therapy are you going to get?", because I know that many assume they'll get all they need. After all, that's why we're paying for health insurance, right?
While it is true that most patients don't' get enough speech therapy, it turns out many patients could get more the insurance company to pay for more therapy. Here's why they don't.

Insurance companies often authorize only a a few hours of treatment per week. (The research data shows it's about 1-5 hours per week) but the research also shows that you need about 9 hours per week for it to be effective.  The data from speech therapists shows that patients are also 4x as likely to be discharged due to lack of progress than lack of benefits. So insurance companies don't provide enough therapy, then cancel it when (surprise!) you don't make progress. If you're in that boat, you may want to see how I solved that problem myself when I had to got to the PT. (Read how I got an extra 100 hours of practice).

Patients need twice therapy they get

The research shows that they get (per week) 1-5 hours, but need about 9 hours.

In sum, there is good evidence that SLT (Speech  Therapy) benefits patients' functional communication, receptive and expressive language compared to no SLT and it is likely that results are better with intensive rather than low-frequency treatment. There is no evidence that any of the discussed therapies is superior to the others (Brady et al., 2012). Aphasia treatment is usually provided at the intensity of one to five hours per week on average. Recent studies seem to suggest that treatment of such intensity is likely insufficient and it is estimated that almost twice this intensity[ hours per week] is required to achieve significant treatment effects beyond spontaneous recovery (Code and Petheram, 2011).

Recent advances in the treatment of post-stroke aphasia
, Neural Regeneration Research, Zumbansen, A. & Thiel, A. (2014). . URL

But resources not available for this Speech Therapy

(above source continues)

However increasing treatment intensity [hours per week] often is not feasible due to economic limitations in most public health systems but also due to the lack of various other resources, such as time and space (Rose et al., 2014). Thus, research on non-behavioral supplementary treatments is needed, which may potentiate the effectiveness of SLT, particularly in acute and subacute stages where the SLT is currently provided with highest intensity (Katz et al., 2000; Verna et al., 2009). Such possible adjuvant strategies may comprise pharmacological approaches as well as non-invasive brain stimulation (NIBS).

Empirical Data: Treatment should be 9h per week  but it's less than 5

Code, C, Petheram, B 2011. Delivering for aphasia. International Journal of Speech-Language Pathology, 13(1), Pp. 3--10.
Average hours of treatment for aphasic people in the developed world ranges between 1–5 hours per week, with a great deal of variability, although recent research suggests that intense treatment of 9 hours per week over a relatively short period is needed in order to be effective. It is concluded that there is a significant gap between what the research suggests is the appropriate amount of treatment and actual provision throughout the English-speaking world.


Therapy ends due to lack of Progress, not lack of Insurance Benefits

If patients made more progress they might get more Treatment. Outpatients (who are traveling to the hospital for therapy) are discharged 18.2% of the time because they have not made progress (Progress Plateaued) but less than 1/4th of that number are discharged for Exhausting Benefits or Denied Coverage ( 3.5% + .8% =4.3%).

Table 12, 2011 NOMS report from the American Speech-Language Hearing Association (ASHA) on resons for Outpatients to be discharged from therapy


26% of Patients Discharged Needing More Treatment

From 2006 to 2010, 26.4% of patients were discharged needing more therapy.

From ASHA's Outpatient NOMS 2006-2010, page 15. ASHA is the American Speech-Hearing Association, which licenses and oversees Speech-Language Pathologists.

And since these are Outpatients, meaning they were not in the hospital, many, if not most, are discharged to home, with no other option for therapy except out-of-pocket.

Also, note that if a therapist recommends further therapy, the patient is going to expect them to provide it or explain why insurance isn't providing it. This puts therapists in an untenable position if they recommend additional therapy.