An oral appliance can be prescribed as a treatment and would be considered a medically necessary situation with a diagnosis of mild or moderate sleep apnea from our board-certified sleep physician. So for most patients, the answer is "yes".
Two factors will determine your coverage: your plan's allowed amount for an oral appliance and your plan's deductible, which we will determine for you. In most cases, you will have a much higher reimbursement from your medical insurance than from a dental policy (if you have one.) Once your screening is complete, we can provide a "verification of benefits" so you will know what your actual treatment cost will be. Of course, coverage will vary by state, carrier and specific insurance plan.
If you already have a CPAP, but aren't using it don't worry; your medical insurance can cover oral appliance therapy in addition to the CPAP machine you already have. We can work with your doctor to obtain documentation that you are non-compliant with CPAP treatment (like nearly 70% of CPAP users) and get you covered for the new appliance therapy.
The Julian Center works with a 3rd party expert in the field to improve your success of reimbursement. There are no guarantees regarding coverage, that is why it is imperative to receive VOB and Pre-Authorizations from your insurance company prior to beginning treatment.
Remember your insurance company is not your best advocate when it comes to your health. You may need to invest in this treatment to save your life, regardless of the insurance coverage.
If you are not sure if you are at risk for sleep apnea, take our FREE online assessment here.
For more information, please call our office or use the online form to request a consultation to find out if your insurance will cover sleep dentistry and oral appliances.