We have spent numerous hours of continuing education in the area of sleep apnea and sleep breathing disorders over the past five years. As we explain the health ramifications of Obstructive Sleep Apnea to our clients, one of the questions that often arises is, “Will my insurance pay for the treatment if I use an oral appliance?”
It is important to understand a couple of issues: One, this is a medical problem, not dental, so you will be utilizing your medical insurance. There is no dental coverage for the treatment of snoring or sleep apnea. Two, we are not contracting providers so you will be out of network – there are not any dentists that are in network with medical insurance companies for the use of oral appliances.
Realize that our team is well versed in, and happy to guide you through, the insurance process and coaching you on what questions to ask your insurance representative. When all of the required information has been collected we can send a pre-authorization of benefits to your medical insurance company to determine the amount they will pay.
For insurance to provide coverage three things are usually required: 1. a sleep study 2. a diagnosis of OSA and 3. a CPAP intolerant statement. Unfortunately, although snoring can be incredibly disruptive to your sleep and those people close to you, this is not considered a medical necessity and therefore no insurance coverage will be available. The general rule is the more proactive you are, the smoother and quicker the process will be of determining your insurance benefit.
When you are ready to improve your sleep and your health, or have insurance questions, please contact us.