I’m Confused- Does Insurance Cover Sleep Apnea?

September 12, 2023

Filed under: Uncategorized — starsleepplano @ 6:21 pm
Desktop view in front of a sunny window with someone filling out insurance forms in front of a laptop

No one wants to wake up from a full night’s rest still feeling exhausted, but if you have sleep apnea, this could be a daily struggle. If you’ve been diagnosed with this disorder, your breathing is regularly interrupted at night. That means you’re not effectively cycling through the sleep stages to really restore your mind and body. Thankfully, there are treatments available, but you might have questions. How do you get started? Where do you go? Will insurance help pay for appointments or equipment? Keep reading to find out!

Diagnosing Sleep Apnea

Fortunately, sleep apnea is usually treatable, but you’ll need an official diagnosis, first. To do that, you’ll need a referral from your doctor or dentist for a sleep study. Usually, you’ll go to a special lab setup for this purpose, but in some cases, it’s done with an at-home device. Either way, your breathing patterns and heart rate will be monitored while you sleep through the night. That data is analyzed by sleep physicians who can then provide a formal diagnosis. After that, your dentist can help devise a plan based on the form and cause of your sleep apnea.

Because this testing is technically all part of a medical diagnosis, it’s often covered by medical insurance policies.

How Is It Treated?

The method of addressing sleep apnea depends on what’s causing it. If it’s due to health reasons like diet or smoking, your doctor will suggest healthy changes. In many cases, a CPAP (continuous positive airway pressure) machine is prescribed. This consists of a mask that you wear over your nose and mouth at night that helps keep your upper airway passages open with consistent, gentle air pressure. There are also other oral devices available that can help if you don’t have success with a CPAP machine. Your dentist will go over the options based on your specific circumstances.

If your sleep apnea is due to some other medical condition like heart or neurotransmitter disorders, treating the cause usually addresses this symptom.

Does Insurance Cover Sleep Apnea?

Sleep apnea is still considered a medical condition. That means that different aspects of treatment can be covered by medical insurance (hooray)! That’s why an official diagnosis is so important; without it, you can’t claim your visits or devices for insurance coverage. Each insurance plan is different, though, so it’s important to find out what’s included in yours. If you don’t know, it’s best to call your health insurance provider (usually the phone number is on the back of your insurance card). They can help you understand how to use your benefits for your sleep apnea.

Insurance can often cover different aspects of your appointments to diagnose your sleep apnea, and often cover oral devices or CPAP machines as medical equipment expenditures. That’s great news if budget was keeping you from addressing your sleep apnea! Make an appointment today and you’ll be on your way to a blissful night’s sleep.

About the Practice

At Star Sleep & Wellness in Plano, you can expect one-on-one attention from a team of board-certified sleep doctors. We can diagnose your sleep apnea at our in-house sleep testing site, so you don’t have to visit multiple locations for appointments and treatment. Our team is happy to help review your insurance plan and obtain pre-authorizations to minimize the cost to you. If you’d like to schedule a visit, you are welcome to contact us on our website or by calling (214) 750-7776.