35 Myofunctional Therapy Covered By Insurance

Orofacial Myofunctional Disorder A Mouthful Boise Speech and Hearing Clinic
Orofacial Myofunctional Disorder A Mouthful Boise Speech and Hearing Clinic from boiseshc.com


Myofunctional therapy is a growing field in the realm of oral health. It focuses on correcting abnormal oral habits and improving the function of the muscles and structures in the mouth. This therapy can be beneficial for individuals with various oral issues, such as tongue thrust, improper swallowing, and breathing difficulties. However, one major concern for many people considering myofunctional therapy is whether it is covered by insurance. In this article, we will explore the topic of myofunctional therapy and delve into the details of insurance coverage.

What is Myofunctional Therapy?

Before we dive into the details of insurance coverage, let's first understand what myofunctional therapy entails. Myofunctional therapy is a specialized treatment that aims to correct improper oral habits and improve the function of the muscles involved in speech, swallowing, and breathing. It involves a series of exercises and techniques that target specific muscles in the mouth and face.

The Benefits of Myofunctional Therapy

There are several benefits to undergoing myofunctional therapy, including:

  • Improved speech articulation
  • Correction of tongue thrust
  • Improved swallowing function
  • Enhanced breathing patterns
  • Reduced risk of developing orthodontic issues
  • Improved overall oral health

Who Can Benefit from Myofunctional Therapy?

Myofunctional therapy can be beneficial for individuals of all ages, from children to adults. It is often recommended for those who have orofacial myofunctional disorders, which refer to any abnormal patterns of muscle function in the mouth and face. Common conditions that can be treated with myofunctional therapy include:

  • Tongue thrust
  • Open mouth posture
  • Thumb sucking
  • Lip incompetence
  • Snoring and sleep apnea
  • Temporomandibular joint disorders (TMJ)

Insurance Coverage for Myofunctional Therapy

Understanding Insurance Coverage

Insurance coverage for myofunctional therapy can vary depending on the insurance provider and the specific policy. It is essential to have a clear understanding of your insurance coverage before starting treatment. Here are some key points to consider:

  • Check if myofunctional therapy is covered under your dental or medical insurance
  • Review your policy to understand the coverage limits and any exclusions
  • Find out if a referral from a healthcare professional is required
  • Check if there are any pre-authorization requirements
  • Understand the co-payment or deductible amount you may be responsible for

Types of Insurance that Cover Myofunctional Therapy

While coverage for myofunctional therapy can vary, it is generally more likely to be covered under medical insurance rather than dental insurance. Medical insurance providers often recognize the therapeutic benefits of myofunctional therapy in treating various orofacial disorders. However, it is essential to check with your specific insurance provider to determine the coverage.

Steps to Take for Insurance Coverage

If you are considering myofunctional therapy and want to explore insurance coverage options, here are some steps you can take:

  • Contact your insurance provider and inquire about coverage for myofunctional therapy
  • Ask for a list of in-network therapists or clinics that offer myofunctional therapy
  • Obtain a referral from a healthcare professional, if required by your insurance
  • Submit the necessary documentation, including treatment plans and cost estimates, to the insurance company
  • Follow up with the insurance company to ensure timely processing of your claim

Alternative Options for Coverage

Flexible Spending Accounts (FSAs)

If myofunctional therapy is not covered by your insurance, you may still have alternative options for coverage. One such option is utilizing a Flexible Spending Account (FSA). FSAs allow you to set aside pre-tax dollars to cover eligible medical expenses, including myofunctional therapy. Check with your employer to see if you have access to an FSA and what expenses are eligible for reimbursement.

Health Savings Accounts (HSAs)

Another alternative option for coverage is a Health Savings Account (HSA). HSAs are similar to FSAs, but they are available to individuals who have a high-deductible health plan. Contributions to an HSA are tax-deductible, and the funds can be used to cover eligible medical expenses, including myofunctional therapy. Speak with your healthcare provider or financial advisor to see if an HSA is a viable option for you.

Payment Plans and Financing Options

If insurance coverage or alternative accounts are not available to you, many myofunctional therapists offer payment plans or financing options to make the treatment more affordable. These options allow you to spread out the cost of therapy over time, making it more manageable for your budget. Reach out to your chosen therapist or clinic to inquire about any available payment plans or financing options.


Myofunctional therapy can be a valuable treatment option for individuals with various orofacial disorders. While insurance coverage for myofunctional therapy can vary, it is worth exploring your options to determine if it is covered under your plan. Contact your insurance provider, inquire about coverage, and consider alternative options such as FSAs or HSAs. Remember to review your policy, understand the coverage limits, and follow the necessary steps to ensure reimbursement. With the right information and guidance, you can navigate insurance coverage for myofunctional therapy and access the treatment you need for improved oral health.