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Does insurance cover costs associated with oral appliance for sleep apnea?

August 17, 2017

Does insurance cover costs associated with oral appliance for sleep apnea?

One of the most common questions that people who are suffering from sleep apnea ask is whether their sleep apnea dental device cost is covered by their health insurance since these appliances tend to be expensive. Though the terminology is related to dental, typically the device cost will not be covered by your dental insurance, but rather by your health insurance. To understand these aspects better, considering the below-mentioned factors is crucial.

  • Go through the coverage details

First and foremost, read your medical insurance terms carefully to have a clearer understanding about its coverage of the sleep apnea dental device cost. You must also know about the particular types of snore mouthpieces that fall under medical insurance coverage. It has been observed that majority of the commercial and medical insurances offer coverage for those oral appliances that are FDA approved or prescribed by certified dentists.

  • Check the coverage percentage

Once you know that the oral appliance you’ve chosen comes under insurance coverage, analyze the coverage amount. Depending on your health insurance for 100% coverage of your expensive oral appliance might not be logical. Though the insurers cannot always give the exact coverage details before you buy the appliance, having a rough estimate will let you be aware of the amount that will be reimbursed by the insurance company.

  • Know about the restrictions

Though the majority of the modern-day health insurances offer different coverage options to manage sleep apnea dental device cost, sometimes there are few restrictions. For example, if you buy an oral appliance for treating your snoring issues, the insurance will not bear any coverage for the tool. Documenting the medical necessity along with your medical history may play a part in determining the restrictions.

Note that since the medical insurance company must adhere to the Academy of Sleep Medicine Practice Parameters, if you satisfy the criteria, you will be able to avail the insurance benefits to the maximum and save on sleep apnea dental device cost. Hence there is no cause for concern in this regard.

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