I'm having a hard time sleeping. The best I can tell is, it seems I have lost ability to breath when I totally relax to sleep. I'm at a loss as to what to do. I'm covered by medicare A and B and a supplementary. Will this cover me? What should I do?
Doctors Answers (7)
Yes, insurance will cover sleep apnea treatment.
We are a contracted Medicare Part B provider and a diagnostic sleep study is a covered benefit. We would still contact Medicare and confirm that the plan is traditional part B & not a managed care plan or there are no other coverage issues.
Medicare does have coverage for oral sleep appliances to treat sleep apnea, however, you would need to do research and find a dentist that is a DME (Durable Medical Equipment) provider.
Yes, Medicare covers the diagnostic and treatment components of sleep apnea. They realize that treating sleep apnea is more cost effective than the consequences of not treating the disorder.
The first step is having a diagnosis from a Doctor of Sleep apnea. CPAP is one treatment of Sleep Apnea, but oral appliance therapy is another less evasive option. Our Dentist offers a complementary initial appointment to discuss signs and symptoms of Sleep Apnea. She also shows our patients the oral appliance we recommend, and discuss the benefits of the device. If the patient is ready to proceed, an impression will be taken during the appointment. In about 3-4 weeks the appliance will come back from the lab. Talk to your primary care physician and/or sleep physician today. Sleep Apnea is a serious medical condition, if left untreated it could have dire consequences.
Oral Appliance therapy is usually covered by insurance. Medicare usually contributes towards the expense of an oral appliance, although as of January 1st 2013 Medicare only covers a couple types of oral appliance devices. You may want to check with Medicare, to understand the limitations and coverage.
Yes, it sounds like your symptoms are very suggestive of sleep apnea. We would discuss a sleep study and CPAP or other options as treatment during a consultation appointment. Medicare B does cover our services at 80% and supplements usually pick up whatever is left over. This includes both the sleep study and the CPAP equipment and supplies. We have a full time benefits coordinator on staff that always contacts our patients' insurance provider to verify coverage and document benefit coverage. We do not require a referral from a primary care provider. Some insurances rarely still require a referral and we would always let you know if your insurance does. Medicare does not require a referral. Thank you!
Thank you for your question. Yes, most insurances cover sleep diagnostic testing and CPAP machine and supplies. Medicare is one of the insurances that cover this service. I will be happy to verify your secondary insurance and make certain if you will have any out of pocket expense. Please call with insurance information if you would like us to do that. If you are unsure, I would be happy to schedule an appointment for you with Dr. Gibson who is a Board Certified Sleep Specialist. You can discuss your experiences with him and the two of you can then decide if you are a candidate for a sleep study. If so, then we will gladly schedule your sleep study. Please call with any questions.