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In most situations, sleep apnea insurance coverage is handled through medical, not dental insurance. Depending on your individual plan, it may vary as to how much your insurer will agree to pay for treatment, sleep studies, and even home sleep testing. In order to find out how much your portion of the overall cost will be, read on to learn more about how involved your insurance company will be in handling or paying for your ability to receive adequate rest.
Will Insurance Cover Lab-Based or In-Home Sleep Studies?
When it comes to a sleep study, you can expect most major medical insurance companies and Medicare to cover the cost. In the past, sleep lab testing was the only way a patient could receive coverage; however, more and more insurance companies are now paying for in-home sleep studies, especially when attempting to diagnose Obstructive Sleep Apnea (OSA).
It is important for you to review your policy as thoroughly as possible since some companies have stipulations. For example, it may be necessary for you to have a home sleep test before they will agree to pay for an in-lab sleep test, which is often more costly.
As long as your physician or dentist prescribes a sleep study, your insurance company will pay for it; however, you will responsible for any co-pays or deductible.
Can You Expect Your Insurance to Cover Treatment?
Once you’ve made it past the first hurdle of having your insurance pay for your sleep study, you’ll need to find out whether treatment is covered. Many dentists offer oral appliance therapy because of its great success and more comfortable method of treatment; however, many insurance companies will only pay for a CPAP or bi-level device. This can be problematic if this type of treatment is uncomfortable or poses difficulties in your ability to maneuver the device.
Fortunately, some sleep dentists offer treatment financing through companies such as CareCredit. As a third-party financier, CareCredit makes it possible for patients to receive low-to-no interest payments plans, so treatment is not only possible but also affordable.
If you believe you might have sleep apnea but are unsure how you’ll pay for your treatment, talk to your dentist or physician about what you can do. Avoiding your symptoms and living a life that involves restless sleep is not possible, so make your health a priority and find out how your insurance company can help you get the rest you need.
About the Author
Dr. Shelley Shults wants you to receive the care you need. When it comes to sleep apnea, some insurance companies may or may not cover parts of your treatment. This is why her team members will be happy to walk through the process with you, discussing with your insurance company about the level of coverage and ways you can save money in the process.
As a board-certified registered nurse, general dentist, family nurse practitioner, and dental sleep medicine practitioner, Dr. Shults graduated from Wichita State University with a bachelor’s degree in Nursing. In 2001, she graduated from The Ohio State University with a Doctor of Dental Surgery degree. She then received her MATRx certification in sleep apnea in 2013. To learn more, contact us at (614) 396-9310.