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How Medical Insurance Can Help Pay for Sleep Apnea Therapy

April 29, 2021

Filed under: Uncategorized — sleepsolutionstopeka @ 6:36 am
Person managing cost of sleep apnea therapy with medical insurance

Whether you’ve been diagnosed with sleep apnea or you’re considering a sleep study to confirm a diagnosis, it’s incredibly important to pursue professional treatment as soon as you can. Not only does sleep apnea make it difficult to stay asleep through the night and feel well-rested in the morning, but this chronic condition can put you at higher risk for other debilitating problems (including depression, type 2 diabetes, heart attacks, and other health issues.) Thankfully, there are ways to make the cost of sleep apnea therapy more affordable when you have medical insurance! Here’s what you should know.

Will Medical Insurance Cover Costs for Sleep Studies?

It’s unlikely that a dental insurance plan will offer any coverage for services related to sleep apnea treatment, but medical insurance plans tend to be more consistent in their coverage. However, every plan is going to have different levels of coverage, which is why it’s so important to look over the details of your plan ahead of time.

In the case of sleep studies, you can usually get coverage if it’s considered to be necessary for a diagnosis or treatment of a disease. After all, sleep studies are performed to identify problems that meet these prerequisites. Just keep in mind that some plans require the sleep study to be performed at home vs. in a medical facility. They do this in order to keep costs as low as possible and can even lower your copayment in some cases.

What About Oral Appliances?

Many medical insurance policies also offer coverage for oral appliances, especially since Medicare approved them back in 2011. These fall into the category of durable medical equipment (DME) and work to manage and reduce the symptoms caused by sleep apnea therapy. DME benefits are considered an essential health benefit in the Affordable Care Act, leading many medical plans to step up and offer better coverage for these types of services.

With that said, it cannot be stressed enough that plans can vary dramatically. The office you’re receiving care from should be more than happy to look over yours with you to ensure you get the biggest reimbursement possible.

What Should I Look for in My Plan?

A good thing to be on the lookout for is your plan’s Summary of Benefits and Coverage letter. This is typically mailed to you or provided by your employer when you sign up for medical insurance. It’s also helpful to login into your provider’s website with the account provided to you, or create one yourself if you have not done so already.

Getting coverage for an oral appliance or sleep study doesn’t have to be a difficult process when you know what to look for. If you need additional guidance, don’t be afraid to ask a sleep dentist in Topeka for help with your plan’s details!

About the Author

Dr. Michel has pursued advanced training and continuing education in his specialty for decades, including the treatment of conditions like sleep apnea through dedicated therapy. Whether you have symptoms that are affecting your sleep quality, are in need of a more detailed diagnosis, or trying to get away from CPAP machines, he’s the professional to see. To schedule an appointment, you can contact him through his website.

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