Are Sleep Apnea Dental Appliances Covered by Insurance?

Appliance therapy is an effective and proven way to treat obstructive sleep apnea (OSA). Oral appliance therapy has become increasingly popular for the treatment of sleep apnea in the Fairview, Allen, and McKinney areas, and for a good reason! It is the easiest way to dramatically improve your quality of sleep, protect your long-term health, and stop snoring.

Of course, the cost of your treatment is a concern for most patients as they wonder, “Will my insurance cover sleep apnea therapy?” or “Will my insurance cover a dental appliance?”. But don’t fret! We’re going to answer that question, as well as a few others, so you can get the quality sleep you need while saving money.

Sleep apnea patients

What is sleep apnea dental appliance therapy?

Sleep apnea, also known as sleep disorder, is a serious problem that affects many people. Most people do not know they have it until their sleeping partner tells them or their doctor or dentist tells them they might have it. It is characterized by pauses in breathing or shallow breaths during sleep. These pauses in breathing can last for up to 10 seconds, or even longer! Using a sleep apnea oral appliance is one way of treating sleep apnea. Oral appliances are custom made oral devices that fit comfortably in your mouth, and can decrease snoring and help with obstructive sleep apnea (OSA).

How does dental appliance therapy help with sleep apnea?

The dental appliance / oral device used for sleep apnea treatment is generally worn only at night while you sleep. They fit and feel much like a sports mouth guard or an orthodontic retainer. The purpose of the appliance is to support the jaw and keep it open, which allows air to flow constantly during sleep. 

Is sleep apnea dental device covered by insurance?

At this time, most dental insurance companies do not offer coverage for oral appliances that treat sleep apnea, and generally, only medical insurance carriers cover them. The first step in getting started with an oral appliance is to contact your medical insurance provider (i.e., Blue Cross/Blue Shield, Medicare, CIGNA) to confirm that the sleep appliance you are interested in will be covered 100% or only a certain amount. In most cases, health insurance covers the majority of the cost, but coverage for  sleep apnea treatment will vary from one insurance plan to another. If you’re unsure how to reach your healthcare carrier or need assistance, please call Sloan Creek Dental in Fairview, TX, and we can help you find out what your coverage will be.

Where can I find out if my dental appliance is covered by insurance?

If you’re not sure what your health insurance plan covers, you are not alone. The most common question about insurance coverage is, “Is this treatment covered?” To find this information out, you can look for your policy’s Summary of Benefits and Coverage letter. To find out, you can either reach out to your insurance company or go online and check your account. You will want to look for the following information:

  • Is the sleep study covered?
  • Is oral appliance therapy / oral device covered?
  • Are there any restrictions on coverage?
  • Is my doctor in-network? 

What is the deductible like for a sleep appliance?

Most insurance plans treat a sleep oral appliance as Durable Medical Equipment (DME). This differs from your yearly plan deductible and will vary from one medical insurance carrier to another, so please refer to your policy for details on how it covers DME.

Common questions on Obstructive Sleep Apnea

Unfortunately, snoring is not viewed as a serious condition by the medical community, and therefore it is not covered by insurance. However, if snoring is one of the symptoms of obstructive sleep apnea, then treating your sleep apnea will greatly reduce your snoring and, in some cases, eliminate it.

Dr. Feng will meet with you for an initial consultation to discuss your concerns. Before the appointment, please call our office to provide us with your medical insurance card information so that we can contact your insurance company before you arrive for your appointment. This will help you avoid any surprises about what your insurance will cover and what portion of the cost you’ll have to pay for the sleep apnea appliance.

Yes. Only dentists and dental specialists are licensed to perform oral appliance therapy to treat obstructive sleep apnea. While internet devices may be less expensive than professional treatment, they are not professionally tested, they can mask severe sleep disturbance problems, cause TMJ (jaw) problems, and negatively alter the shape of your bite.

To treat sleep apnea, your doctor will ask you to stay overnight at a sleep lab or do a home sleep study, also known as a polysomnogram (PSG). The sleep test will record and monitor your brain waves, heart rate, breathing patterns, and muscle movements while you sleep. This test will help your doctor determine if you have sleep apnea and how severe it is.

If your sleep doctor recommends a sleep appliance for mild or moderate sleep apnea, and you have decided that this treatment option will be the best way to treat your sleep apnea disorder. Your sleep doctor will write you a custom-made dental appliance device prescription. Once you have your prescription, you will go back to your dentist so that they can fit the appliance for you.

How do I know if an oral device is right for me?

If you have obstructive sleep apnea, want to know how to get an oral appliance for sleep apnea, questions about a sleep study, or looking for relief other than a CPAP machine, contact Sloan Creek Dental. Our experienced dentist and team can help you navigate the process from beginning to end for a more restful sleep.

You can reach us at our Fairview, TX dental office to schedule an in-person consultation with us today – 972-468-1440. Our dental office is located in Fairview, Texas, and our patients visit us from across the surrounding areas, including Allen, Plano, McKinney, and Lucas.