Is Myofunctional Therapy Covered by Insurance? Here’s What You Need To Know

Patients often ask, “is myofunctional therapy covered by insurance?” In some cases, they also ask, “What is myofunctional therapy?”

These questions often arise after a dentist, speech therapist, or allied medical professional recommends myofunctional therapy to them or a member of their family. In many cases, a parent learns their child may benefit from seeing a myofunctional therapist. These choices can be overwhelming even without factoring in health insurance.

The answer varies by the insurance plan. However, myofunctional therapy is a cutting-edge and emerging treatment. Not all insurance companies have started covering it or fully understand it.

This article isn’t a substitute for individual medical, dental or financial advice from professionals. We are simply providing it as a starting point as you explore the best options for your own health and the wellbeing of your family.

Our first piece of advice is to contact your insurance provider and ask whether they cover myofunctional therapy.

Even more importantly, when it comes to wellness, we encourage all our patients to prioritize treatments that best meet their individual and family needs.

Many different wellness practices may greatly enhance your or your child’s health and quality of life not covered by health insurance plans. For example, yoga, massage, eating organic food, support groups, and even some physical therapy are rarely covered by medical or dental insurance that greatly enhances an individual’s wellbeing and health. When people think about how much they already invest in wellness, they often realize that an investment in myofunctional therapy isn’t much different.

What is Myofunctional Therapy?

Basically, we often compare myofunctional therapy to physical therapy and occupational therapy.

It is an exercise-based treatment strategy focused on the tongue, mouth, and face muscles. The exercises are designed to train the muscles for proper breathing, improved speaking, more efficient chewing and swallowing.

Myofunctional therapy treats Orofacial Myofunctional Disorders (OMDs). These are a variety of disorders impacting the muscles of the face and mouth and how they function. OMDs may directly or indirectly affect facial skeletal growth, an infant’s ability to breastfeed, facial development, chewing, swallowing, speech, oral hygiene, and more. Some also use the therapy to help mitigate sleep apnea or mouth breathing.

The idea is by training the muscles to serve their function better. The patient may be able to develop healthier habits and more optimal function. Some issues addressed might include tongue-tie, mouth breathing during sleep, sleep apnea, disordered breathing, habits like unhealthy oral rest posture, and more.

The therapists may also use other treatment strategies such as gentle mouth taping to help correct specific breathing issues.

Some OMDs are the result of genetics, while others are the result of habit, conditioning, or environment. The treatment plans are individually customized depending on the issues, any negative impact, and the cause. For example, habitual thumb sucking and thrusting the tongue forward sometimes exacerbates OMDs. A treatment plan might address any imbalances or habits to help move towards an ideal function.

As a multidisciplinary field, myofunctional therapy is sometimes combined with other treatments, including surgery, dental care, speech therapy, and more. Often the allied therapies are covered by health insurance.

The Value of Myofunctional Therapy

The Academy of Orofacial Myofunctional Therapy describes its goal as helping people “regain the joy of eating, speaking, breathing, and even sleeping more soundly.” Imagine the value of any treatment that helps a child or adult speak confidently, breath better, sleep soundly, or enjoy eating!

The value to an individual depends on the specific OMD and its severity. For a child who has trouble swallowing and learning to speak, effective myofunctional therapy may be “priceless” as it sets them up for healthier development and a better life. Exercises that correct habitual mouth breathing may prevent developmental issues as sometimes breathing through the mouth too much can alter facial features and even facial skeletal development.

For someone else with a minor, barely noticeable issue, it may not feel as crucial. Each individual is unique, and each treatment plan is just as unique.

Paying for Myofunctional Therapy If Insurance Doesn’t Cover It

It may be frustrating if insurance doesn’t cover the myofunctional therapy you believe is a great option for you or your child’s needs. The good news is that there are options to make it fit within your household budget.

Talk with your provider about the costs and a payment schedule. Sometimes people find the treatment surprisingly affordable, especially when compared to other personal development and wellness expenses. If you have an HSA, look into whether the therapy may be covered.

Even more importantly, talk with your therapist about how to best ensure you get your money’s worth from the treatment. For example, if your child is receiving myofunctional therapy, make sure they do their exercises as frequently as the therapist recommends. Following the treatment plan as recommended results in better success and a smaller chance of needing additional therapy sessions beyond the plan.

Next Steps: Schedule an Appointment or Consultation

If your doctor, teacher, or dentist suggested myofunctional therapy for yourself or a family member, your first step is scheduling a consultation with a therapist. Myofunctional therapy is a multi-disciplinary approach that may involve physical therapists, dentists, speech therapists, and other allied professionals.

Here at Southview Dentistry, we are pleased to offer myofunctional therapy to our patients in the Charlotte, NC, area. We feel privileged that patients trust us with their health and their family’s health.

Southview Dentistry’s own Dr. Kelly Wilson is a trained and experienced myofunctional therapist who is available for your family needs. We always aim to treat our patients holistically, whether adults or small children.

Contact us today to schedule a consultation and learn more about whether myofunctional therapy is the right choice for you or your family.