Does Insurance Cover My Sleep Apnea Oral Device?
If you’ve been diagnosed with obstructive sleep apnea (OSA) and are considering a mandibular advancement device (MAD) as a treatment option, you might be wondering if your insurance will help cover the costs. The good news is that most medical insurance plans do provide coverage for MADs as an effective treatment for OSA—provided you meet the necessary criteria.
1. Medical, Not Dental Insurance, Covers MADs for OSA
One important distinction is that mandibular advancement devices (MADs) for obstructive sleep apnea (OSA) are covered under medical insurance, not dental insurance. While MADs are commonly referred to as dental devices, they treat a medical condition, so claims are processed through your medical policy.
2. Good News: Most Medical Insurers Cover MADs for OSA
The majority of medical insurers do offer coverage for MADs, provided you meet criteria. You’ll need a sleep test to show your diagnosis of OSA a prescription from a physician. For many a convenient at-home sleep test is appropriate, and companies like Daybreak offer a fully at-home testing solution to make the process easier.
3. Medical Plan Considerations
While most medical insurance plans cover oral appliances for sleep apnea if you meet the required criteria, your plan's features will determine if it is fully covered, or if you will cover a portion out-of-pocket. For example, the amount remaining on your deductible and what percentage of the cost your plan says you’re responsible for versus what your insurer will cover (coinsurance) can apply. Some insurance plans require a pre-authorization request before approving coverage, which are typically submitted by your provider on your behalf. For patients with severe OSA, insurers often require an attempt at CPAP therapy first, although some plans may allow severe patients to refuse CPAP instead.
Convenient Testing and Treatment with Daybreak
At Daybreak, we simplify the process by offering:
- Fully at-home sleep testing to diagnose OSA.
- Custom-made mandibular advancement devices for patients who qualify.
- Assistance with medical insurance to help you navigate coverage requirements.
If you’re struggling with sleep apnea or snoring, our FDA-cleared solutions are effective, convenient, and backed by medical expertise.
Take the Next Step Toward Better Sleep
Sleep apnea is treatable, and with the right information and support, accessing your insurance benefits for an MAD can be straightforward. Contact Daybreak today to learn more about our testing and treatment options and how we work with your insurance to provide the care you need.