Medicare: Sleep Apnea Coverage


Snoring may be a sign of obstructive sleep apnea.

Photo By WavebreakMediaMicro

Obstructive sleep apnea affects many people and may eventually lead to health problems if left untreated. Medicare may be able to cover many of the costs associated with CPAP therapy for treatment. Getting treated is very important as it will decrease the risks of serious health conditions and improve overall health.

Warning Signs

There are several different warning signs that you may observe if you are experiencing sleep apnea. You may notice that you have become excessively tired during the days and at night you may be snoring loudly enough to wake the people near you. Additionally, you could experience pauses in your breathing at night or find yourself waking suddenly gasping or choking. While it may not seem like a big deal at first, the condition can leave you at increased risk for developing serious conditions such as diabetes, heart disease, and cognitive decline. Meeting with your doctor to determine the seriousness of your symptoms is imperative.

Corrective Therapy

Once you have met with your doctor and assessed symptoms, it is likely that you will be referred to a sleep testing center for additional testing. The testing there will definitively confirm or deny the occurrence of sleep apnea. An overnight stay will be required so that monitoring can take place while you sleep. Breathing, heart rate, oxygen levels, and movement will all be monitored throughout the night. The information will provide answers to what exactly is causing the apneas to occur. There are several different types of sleep apnea but the most common is obstructive sleep apnea. Moderate to severe cases are most often treated through the use of CPAP therapy. This therapy utilizes a face mask to deliver air pressure directly to your airways. This keeps your airways open and prevents them from closing while you sleep.

Coverage Through Medicare

Medicare Part B may provide assistance covering most of the costs of CPAP therapy. In order to qualify, you must first receive a diagnosis of obstructive sleep apnea. Once approved, Medicare will cover an initial 3-month trial rental of a CPAP machine. If your doctor is able to confirm that the therapy is helping your condition, Medicare may then approve an additional 10 months of coverage. After completing a 13-month total rental, you may own the CPAP equipment. While Medicare will likely be able to cover the bulk of costs, you will be responsible for 20% of the Medicare-approved costs. Your Part B deductible will also apply.

 

Life Insurance Questions?

We hope that this information on Medicare’s coverage for obstructive sleep apnea is useful to you.

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About Cali Naughton

Cali Naughton graduated from the University of Texas at Arlington. She joined the marketing team at Empower Brokerage in the spring of 2021 as a marketing specialist and the department photographer.

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