Why I Choose to Only Accept Private Pay and HSA/FSA Cards in My Private Practice (And How You Can Still Get Support)

Why I Choose to Only Accept Private Pay and HSA/FSA Cards in My Private Practice (And How You Can Still Get Support)

Why I Choose to Only Accept Private Pay and HSA/FSA Cards in My Private Practice (And How You Can Still Get Support)

Running a private practice means making choices that prioritize the best care for my clients and sustainability for my services. One of the most important—and often misunderstood—decisions I’ve made is to operate as a private pay only practice, accepting Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA) cards, but not billing insurance directly. 

This decision isn't about turning families away—it’s about providing consistent, quality care, cutting through red tape, and focusing on what matters most: your child’s progress. Learn more about my therapy services here.

Why I Don’t Accept Insurance

Here are a few key reasons I’ve chosen not to work with insurance companies:

1. Client Centered Treatment Over Insurance Driven Limits

Insurance often dictates the frequency, type, and duration of therapy sessions. As a clinician, I want to use clinical judgment—not insurance policies—to determine the best treatment plan for each individual.

2. More Time With Clients, Less Time With Paperwork

Insurance billing requires hours of documentation, claim submissions, appeals, and follow-up. That’s time that could be spent preparing for sessions, learning new techniques, or simply providing more meaningful support to my clients and their families.

3. Transparency and Predictability

With private pay, you’ll always know the cost upfront. There are no surprise denials, deductibles, or out-of-pocket maximums. You pay for the service you receive—simple and clear.

4. HSA/FSA Flexibility

Many families use Health Savings Accounts (HSAs) or Flexible Spending Accounts (FSAs) to cover therapy costs. These accounts allow you to use pre-tax dollars to pay for eligible healthcare expenses, including speech, occupational, and behavioral therapy, depending on your plan.

Alternative Funding Sources to Help Cover Costs

I understand that private pay can be a stretch for some families. Thankfully, there are several grant programs that can help cover therapy and related medical expenses for children. Here are five excellent resources:

1. Small Steps in Speech

  • What they fund: Speech and language therapy for children with speech/language disorders.

  • Eligibility:

    • Ages 3 to 22

    • U.S. citizen or permanent resident

    • Not currently receiving funding from other organizations for the same services

    • Recent evaluation report

  • Income: Less than $125,000 joint family income

  • Website: smallstepsinspeech.org

2. UnitedHealthcare Children’s Foundation (UHCCF)

  • What they fund: Medical-related services and therapy, including speech, OT, and behavioral therapy

  • Eligibility:

    • Ages 16 and younger

    • Must have commercial health insurance (not Medicaid/CHIP)

    • U.S. citizen or legal resident

  • Income: Household income limits vary by family size (e.g., under $135,000 for a family of 4)

  • Website: uhccf.org

3. Oracle Health Foundation (formerly Cerner Charitable Foundation)

  • What they fund: Healthcare expenses including therapy, assistive devices, and medical equipment

  • Eligibility:

    • Ages 0 to 18

    • Qualifying income is based on the number of dependent children in the home

    • Services must not be covered (or sufficiently covered) by insurance

  • Income: Sliding scale based on federal poverty guidelines

  • Website: oraclehealthfoundation.org

4. Missouri Assistive Technology (MOAT)

  • What they fund: Assistive technology devices and services for individuals with disabilities in Missouri

  • Eligibility:

    • Missouri resident

    • Has a disability requiring assistive technology for communication, mobility, etc.

  • Income: Considered but not always disqualifying—funding available for a range of situations

  • Website: at.mo.gov

5. Friends of Man

  • What they fund: Therapy expenses, including AAC equipment

  • Eligibility:

    • All ages considered

    • Application must be submitted by a referring professional (e.g., doctor, therapist, social worker)

    • Available to residents of the U.S.

  • Income: Household income of 300% or less of Federal Poverty Guidelines

  • Website: friendsofman.org

In Summary

By choosing private pay and supporting the use of HSA/FSA cards, I can provide flexible, individualized care without insurance imposed barriers. I hope these alternative funding programs can bridge the gap and ensure that your child receives the quality therapy services they deserve.

Let’s work together to find a path that supports your child’s growth—without sacrificing quality or integrity. 

Have questions? Schedule a video call  or email ali@wordplayspeechtherapy.com today. 

If you’re looking for private pay pediatric therapy services in St. Charles county, Missouri or the greater St. Louis area, I’d love to help your child grow with care that’s custom fit to their needs. Contact me today to learn more or ask how I can support your family. 

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