When considering whether or not to pursue sleep apnea treatment, one of the leading factors may be the cost. Is it something your dental or medical insurance can help cover? What kind of out-of-pocket expenses should you expect? These are all reasonable questions to ask, and a skilled sleep expert is here to provide the answers.
Why Won’t Dental Insurance Cover Sleep Apnea Treatment?
Snoring and a blocked airway are both problems that occur inside the mouth, correct? If this is the case, wouldn’t it make sense for your dental insurance provider to help with the cost? Unfortunately, no.
The reason is that sleep apnea affects the body as a whole. Although it starts with mouth breathing and a closed airway, other organs and health-related factors can be negatively impacted without treatment.
Besides, the treatment options used to address sleep apnea are considered medical devices, which are not covered by dental insurance.
Can a Claim Be Filed with Medical Insurance?
In short, yes! Your doctor can file a claim with your medical insurance to help minimize your expected out-of-pocket costs. However, each company and plan is different, so it’s important to review your policy or have a member of your healthcare team do it on your behalf.
To ensure that you get the maximum level of coverage, your doctor will need to complete the appropriate paperwork, detailing the reason for your treatment and which solution is being recommended (i.e., CPAP therapy, oral appliance treatment, weight loss, etc.). This is otherwise known as a pre-authorization.
Since there is likely to be a deductible you’ll need to meet (if you haven’t already) or a co-payment that you’ll make upfront, your insurance company will review the details provided by your doctor and make a decision.
If they approve, you can expect them to pay a portion of the total amount. One important factor to consider is working with a doctor who is in-network with your medical insurance provider. This will ensure that you pay the lowest price for the care you receive.
Being able to afford sleep apnea treatment is one of the leading factors for individuals who are trying to decide whether to pursue essential care. Knowing that you have the support of a trusted sleep dentist and medical insurance plan can make the process less stressful and more enjoyable.
About the Practice
At Star Sleep & Wellness in Denton, our sleep dentists and specialists provide patients with safe and effective solutions for better sleep. We also work closely with different health insurance companies to help individuals pay less for the treatment they receive in our office. If you have questions about how much you can expect your treatment to cost or if your insurance provider will cover any or all of your care, contact us to find out.