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Does Medical Insurance Cover Sleep Apnea Therapy?

April 29, 2021

Filed under: Uncategorized — sleepbetterteam @ 11:38 am
stethoscope on insurance claim form

There are literally millions of Americans who could benefit from sleep apnea treatment right now, but there is a very basic obstacle that is preventing them from pursuing it…the expected expense. Many people are unsure they’ll be able to afford sleep apnea therapy, and of course, this quickly leads to questions about insurance coverage. If you have medical insurance, can you use it to cover the cost of sleep apnea therapy in Wesley Chapel? Read on to find out and get more answers that could help you start the journey toward better sleep and health.

Medical Insurance & Sleep Apnea

In short, yes, most medical insurance plans can be used to help pay for sleep apnea therapy. This includes all phases of the process as well, such as the initial exam, the sleep test, the treatment itself, as well as a follow-up sleep test to make sure the treatment is working.

How to Use Your Medical Insurance for Sleep Apnea

The most direct way to figure out what type of coverage your plan offers for sleep apnea treatment is to read it or talk to your provider. Or, you can contact your primary care physician or a local sleep dentist in Wesley Chapel, and their team can discuss your benefits with you after verifying them.

After an initial exam, you’ll most likely be directed to undergo a sleep test. This can be carried out either in a lab or with an at-home device. Primarily, medical insurance will pay for an at-home test because these tend to cost less. Once you have been officially diagnosed with sleep apnea, the two main options for treatment are CPAP (continuous positive airway pressure) therapy and oral appliance therapy.

Will Medical Insurance Pay for CPAP or Oral Appliance Therapy?

Fortunately, the answer to both questions is yes! Both CPAP machines and sleep oral appliances are considered DME (durable medical equipment, the same classification as wheelchairs) and are therefore included in medical insurance.

Where things potentially get confusing is that oral appliances are typically designed and provided by sleep dentists, but dental insurance often can NOT be used to pay for sleep apnea therapy. Sleep dentists are typically happy to accept medical insurance, however, and they can file your claims for you to make it easy to get your appliance without delay.

What to Do Next

If you believe that sleep apnea is the cause of your constant exhaustion, relentless snoring, and mental fog, you can start the process of getting the care you need while trusting that your medical insurance will make the solution easily affordable. If you have questions, don’t hesitate to contact your provider and ask them directly about your coverage!

About the Author

Dr. Jay A. Nelson has been practicing since 1981 and has completed countless hours of advanced training dedicated to dental sleep medicine. He is also a Diplomate of the American Board of Dental Sleep Medicine. Over the years, he has helped thousands of people start getting the rest they deserve by providing high-quality, custom-made oral appliances. His practice is happy to accept medical insurance from many different providers, and to learn more about your care options and how you can make it affordable, contact us today.

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