In many cases, private or group health insurance will cover all or part of the costs of getting an oral appliance for obstructive sleep apnea (OSA) treatment. This can vary from one insurance policy to another and from Province to Province.
Government and provincial health plans do not cover oral appliance therapy at this time.
How can I predetermine if my medical insurance covers an oral appliance?
Medical Insurers typically cover oral appliances for moderate to severe OSA. This normally means an AHI (Apnea Hypopnia Index) of greater than 15. Patients should call their insurer’s benefits department using the contact number on the medical insurance card. In most cases, a predetermination or pre-authorization will have to be submitted to your insurer prior to treatment to verify your benefits. A fee estimate, a copy of your sleep study, a copy of the Sleep Report from your Sleep Doctor and a prescription for an oral appliance must be submitted. Many insurers have online portals for document submission and pre-authorization requests.
As a patient – what do I ask my insurer?
It is important to check with your insurer as to whether your policy provides coverage before ordering an oral device. Ask your insurer if you have medical coverage for an Adjustable Anterior Mandibular Positioner (AAMP) for the treatment of diagnosed Obstructive Sleep Apnea. It is uncommon, however you can also check if you qualify for coverage of your dental by submitting code 14901 – Appliance, Intraoral, for the treatment of Obstructive Airway Disorders.
If you have previously received coverage for CPAP therapy, it is important to ask if your benefit has time restraints on claims submissions. For example, some policies that have previously covered CPAP therapy within the last 5 years will not cover an oral appliance until 5 years from the last claim.
Does insurance cover snoring devices? An oral appliance for snoring alone is not covered by medical insurance. However, snoring is a symptom of sleep apnea and if OSA is diagnosed, then most medical insurers will offer coverage for an oral appliance.
OADS offers reimbursement services for a small cost. This cost will be covered by the total cost of the device and the Dental Practitioner’s fees.
Over a three-year period, cost of the CPAP, supplies and accessories (mask, hose, filters and water chamber) significantly exceeds cost of an oral appliance. Therefore, cost of an oral appliance is more favorable than the CPAP therapy for self paying patients.
Third Party Financing
Open Airway Dental Solutions offers a hassle-free solution for those seeking their O2Vent device to manage sleep apnea. We provide an in-house, interest-free payment plan with flexible terms, allowing our valuable patients to choose repayment periods spanning up to 12 months.
This approach eases the financial burden, making the O2Vent device more accessible. The process is straightforward, ensuring a convenient experience for customers. With manageable monthly payments, individuals can comfortably acquire the O2Vent device, addressing their sleep apnea needs while avoiding the stress of immediate, full payment.
For more information on Financing Please Contact us at firstname.lastname@example.org or call +1 877-977-8267