Yes, sleep studies are usually covered by health insurance. Most sleep disorder centers are like a normal doctor's office and accept several insurance plans. Does insurance cover sleep studies? The short answer here is YES; sleep studies are covered by almost all insurance. However, some insurance plans have different rules regarding sleep studies than others.
For example, some insurance plans will require a home sleep test (HST) to be done before they cover a laboratory test (PSG). Because HSTs can accurately diagnose 75% of sleep apnea patients who have been properly examined by a doctor, they often don't need to request the PSG study, which is more expensive (albeit more accurate). There is a wide range of prices depending on the type of sleep study (at home or in the center), the type of center (do you bill separately for the study and its interpretation?) and your insurance. Most health insurance plans include coverage for sleep studies with certain providers (see next section below).
Most health insurance plans include coverage for sleep studies with certain providers. Your specific insurance policy will determine the amount of coverage you will receive for the treatment of sleep apnea. Some insurance providers, such as BlueCross BlueShield of North Carolina, will cover certain surgical treatments if you have been diagnosed with sleep apnea and meet specific guidelines. They can also provide some coverage for certain devices, such as MADs or CPAP.
Yes, usually the unsatisfactory answer is: “It depends. But in general, all insurance payers offer some type of reimbursement for sleep studies of all kinds. More revealing than what other Miami hospitals charge for sleep studies is what the University of Miami Health System reports: it actually costs the hospital to perform the procedure. Once that amount is met and you have paid your out-of-pocket ceiling, your insurance will generally begin to cover 100% of the charges.
If you are diagnosed with a sleep disorder, such as sleep apnea, there may be additional expenses to expect. And this is a perfectly reasonable concern, because many health services and procedures can be quite costly, including sleep studies. If you are not sure about coverage, call your insurance company and ask what you need to do to request a pre-determination for a study. Copay The copay (or copay) usually applies to prescription drugs and office visits, but some insurance companies may ask you to pay a small fee (copay) before having a sleep study.
It's reasonable to ask them if they have adequate coverage for an upcoming sleep test, which they understand may be more expensive than many other types of medical tests. First, depending on the type of sleep study your doctor prescribes (learn more about the different types of sleep studies here), you may need to return for a second night sleep study to determine the optimal pressure settings for CPAP therapy (learn more about CPAP therapy for treat sleep apnea here). If you find yourself with symptoms of a sleep disorder and your doctor refers you to a sleep study, almost all insurance programs will cover all or most of the cost. Once a sleep professional has reviewed the HST and found that a PSG is medically necessary, your insurance can agree to pay for a PSG.
Most insurance plans will continue to cover the costs of a PAP machine, but will require proof of patient compliance by the equipment provider before paying for the rent, purchase, or additional replacement supplies of the device in progress. While a home sleep apnea test is a cheaper alternative to a laboratory test, not all patients, especially those with complicated sleep conditions, such as respiratory failure or other comorbidities, can use HSAT as an option. By implementing its best practices of implementing inbound marketing in its medical practice, it converted Alaska Sleep Clinic's once stagnant online presence to the website of the world's busiest sleep centers in just 18 months. You should also be aware that there may be additional expenses in the future if you are diagnosed with sleep apnea.
Before scheduling any sleep study, check with your insurance which clinics are in-network so you don't have to pay a higher bill. . .