SomnoMed device costs vary from patient to patient. Although you visit a dentist for a SomnoDent oral device, the device will most likely not be covered by your dental insurance. SomnoDent oral appliances/devices are covered by many health insurance plans as a medical device to treat sleep apnea. Please contact your health insurance provider for information relative to your specific coverage as deductibles, diagnosis and more are often factored into coverage and overall SomnoMed device coverage.
SomnoMed Device Costs: Facts About Insurance Coverage for SomnoDent Oral Devices
- Oral appliance therapy is virtually always covered by medical insurance and government payers (Medicare, Medicaid, and military) using the same criteria that are used for coverage of continuous positive airway pressure (CPAP) therapy.
- Just like CPAP therapy, there are several required records that the dentist must have in order to acquire coverage, including a written prescription for the appliance from a physician (the family physician or sleep doctor) to treat sleep apnea. However, medical insurance companies do not cover treatment for snoring only.
- In order for a physician to prescribe therapy to treat sleep apnea, a sleep study is required in order to diagnose the patient with sleep apnea. Many payers (insurance companies) require this as well.
- Most insurance companies do NOT require a trial of CPAP or failure of CPAP therapy in order to cover oral appliance therapy.
- Medicaid also usually covers oral appliance therapy, but coverage varies by state.
- Rarely, oral appliance therapy is covered under a dental plan. The VAST majority of the time it is covered under major medical or under the medical insurance DME coverage.
How do I find out how much my health insurance company will cover?
We recommend that you call your insurance company to get information on SomnoMed device costs. Some of the questions you should ask your insurance representative are:
- What is my percentage of coverage for oral appliance therapy for the treatment of obstructive sleep apnea (code #E0486)?
- What is the fee range of coverage?
- Are there any in-network providers for this specific treatment in my insurance plan?
- If there are no providers within the network will my coverage be at an in-network percentage?
- If there are providers within the network, what is my coverage if I see an out-of-network provider?
- Do I need a referral from a physician to see the dentist who treats this problem?
- Do I need a sleep study to qualify for coverage?
Click here to view more information on oral appliance therapy insurance coverage from the National Sleep Foundation.
Have you already had your sleep study?
Did you know there are thousands of dentists trained to help treat and manage your snoring and sleep apnea? SomnoMed manufactures SomnoDent oral devices to help patients treat obstructive sleep apnea and snoring through the use of Continuous Open Airway Therapy (COAT). If you have trouble tolerating Continuous Positive Airway Pressure (CPAP) and need an effective alternative for living with sleep apnea, contact us today to find a SomnoMed dentist near you. Once we connect you with a SomnoMed dentist, the practice will be able to assist you further in determining the overall expenses you can expect for your treatment.
Living With Sleep Apnea Blog: Stocked full of resources and recent news for your treatment journey, the Living with Sleep Apnea Blog is full of information.
Find a SomnoMed Preferred Dentist: Learn more about OSA treatment options and the comfortable, high-quality, and clinically effective line of SomnoDent products. If you are interested in finding a SomnoMed preferred dentist in your area, contact us. Ask your physician or dentist for more information on treating your snoring or mild to moderate sleep apnea with SomnoDent devices. If you are a dentist, please email [email protected] to get your SomnoDent case started.