Speech Generating Devices (SGD)

This policy covers medically necessary speech‑generating devices (including dedicated hardware, enabling software, mounting systems, accessories and upgrades) and related therapy/diagnostic services to improve communication and quality of life for pediatric members with clinical or genetic diagnoses causing low‑tone neuromuscular, neurological, or cognitive impairments that result in a permanent, severe expressive speech impairment. Coverage in Illinois is limited to fully insured (non‑ERISA) plans effective 2025‑01‑01 or later and requires a pre‑delivery independent SLP evaluation documenting that natural modes of communication are insufficient and the child can use the device; consumer computers/phones, hearing aids, shared or non‑dedicated devices, service/home modification charges, multiple SGDs, and devices not meeting policy criteria are excluded.

"Coverage of therapy services necessary to increase quality of life for children clinically or genetically diagnosed with a disease, syndrome, or disorder that includes low tone neuromuscular impair..."