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Is Sleep Apnea Therapy Covered by Your Medical Insurance?

October 22, 2020

Filed under: Uncategorized — estradadds @ 2:01 pm

A good night’s sleep is priceless, but for those who suffer from sleep apnea, treatment does come with a cost. Once your sleep doctor or sleep dentist prescribes sleep apnea therapy in Chesapeake in the form of an oral appliance, you’ll need to find a way to fit it into your budget. The natural question, of course, is whether medical insurance can make this process easier. In many cases, the answer is yes, but since every policy is different, it’s important to review your benefits to make sure. Read on to learn more about how your insurance may be able to help you when you’re looking for a solution to your sleep disorder.

Does Insurance Cover Oral Appliances?

In 2011, Medicare approved oral appliances for coverage. Since then, many other medical plans have started including such appliances, provided that they’ve been approved by the FDA. Of course, before you make a claim, it’s important to double-check your benefits, which you can do by calling the company directly. Under the Affordable Care Act, durable medical equipment, or DME, (which oral appliances are classified as) must be covered by health insurance plans, but requirements might vary by state, which is why it always pays to double-check.

What About Sleep Studies?

Before you can receive any kind of treatment for sleep apnea, of course, you need to be properly diagnosed for the disorder. This requires a sleep study, which can either be performed at home or in a laboratory. Most comprehensive health insurance policies will help pay for both kinds of studies; in other cases, companies such as Aetna will only reimburse home sleep studies provided by a physician in lieu of one where you had to be referred to a separate laboratory. (This is meant to reduce the costs on the insurance company’s end; it can potentially benefit you as well by keeping your copayment to a minimum.)

Does Medicare Pay for Sleep Apnea Oral Appliances?

In order to be eligible for Medicare coverage regarding an oral appliance, you need to meet specific criteria. For example, you’ll need to visit a qualified physician first. Also, the dentist who provides the oral appliance must be enrolled as a Medicare DME Supplier in order to receive reimbursement. Note that DME suppliers are unable to order sleep test for Medicare beneficiaries, so bear that in mind before beginning the process.

If you have any doubts about the cost of sleep apnea therapy in Chesapeake or have questions about the process of making sure that you receive the benefits that you’re entitled to, get in touch with a sleep expert. Make sure that you have as much information as you can so that you can make decisions that are as good for your wallet as they are for your body.

About the Author

Dr. Craig Estrada earned his Doctorate of Dental Surgery degree in 1987 from the Medical College of Virginia School of Dentistry. In order to help as many patients as possible, he has pursued advanced credentials in many different dental fields, including the treatment of sleep apnea and other sleep disorders. If you have questions about oral appliance therapy, get in touch with his practice, Estrada Dentistry, through his website or by calling (727) 869-3886.

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