{"id":28,"date":"2019-04-29T02:52:10","date_gmt":"2019-04-29T06:52:10","guid":{"rendered":"https:\/\/advancedcenterforcosmeticdentistry.com\/blog\/?p=28"},"modified":"2025-10-07T16:02:05","modified_gmt":"2025-10-07T20:02:05","slug":"how-to-use-your-health-insurance-to-cover-sleep-apnea-treatment-with-an-oral-appliance","status":"publish","type":"post","link":"https:\/\/advancedcenterforcosmeticdentistry.com\/blog\/how-to-use-your-health-insurance-to-cover-sleep-apnea-treatment-with-an-oral-appliance\/","title":{"rendered":"How to Use Your Health Insurance to Cover Sleep Apnea Treatment with an Oral Appliance"},"content":{"rendered":"

It\u2019s good news when you\u2019ve found a solution for a restful and healthy night\u2019s sleep. It\u2019s equally good when you discover that your oral sleep appliance can be covered by your health insurance.<\/span><\/p>\n

To clarify, most dental plans will not reimburse you for<\/span> sleep apnea treatment<\/span><\/a>. But before you panic, medical insurance can provide a reimbursement.<\/span><\/p>\n

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The key is in the diagnosis<\/b><\/h3>\n

Your dentist can bill your medical coverage for the appliance. Billing changes and applying specific tips can assist with the process.<\/span><\/p>\n

Again, it\u2019s all about diagnosing your condition and applying the proper coding when billing. Here\u2019s how this applies to us, as your dentist:<\/span><\/p>\n

\u201dAccording to the International Classification of Disease, the medical diagnosis of OSA should be coded as ICD 327.23. This ICD code applies to child or adult OSA when diagnosed by a laboratory or home overnight sleep study and interpreted by a sleep physician. A copy of the sleep study should be sent to the medical insurer with your office notes and a letter of medical necessity or written order from a physician. Medical histories should document high blood pressure, daytime sleepiness, cognitive or mood disorders, heart disease, and other consequences of sleep apnea.\u201d [1]<\/span><\/p>\n

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Getting the most from your medical insurance<\/b><\/h3>\n

It\u2019s common for medical policies to cover oral appliances. Medicare made this possible in 2011. And since then, medical plans have improved their coverage allowances for FDA approved oral devices.<\/span><\/p>\n

To assure that coverage is available, begin by carefully checking your benefits. Do this by phone or request a pre-authorization.<\/span><\/p>\n

And we\u2019re happy to assist if you have any related questions.<\/span><\/p>\n

Oral appliances are considered \u201cdurable medical equipment (DME).\u201d This gives reason for them to be included under your medical coverage following a necessary diagnosis.<\/span><\/p>\n

And if you qualify for Medicare\u2026<\/span><\/p>\n

Approved oral appliances for obstructive sleep apnea are covered. You must meet certain criteria such as:<\/span><\/p>\n