Will my insurance cover an oral appliance to treat sleep apnea?
Most medical insurance carriers (not dental insurance), will cover custom, titratable oral appliance for the treatment of obstructive sleep apnea.
Medical insurance companies will treat an oral appliance as “durable medical equipment”, (DME), just as they do CPAP. Over 100 FDA approved devices are available, and our qualified dentists will help to find the one that is right for you. These devices may carry a separate deductible from the usual annual deductible amount.
Is Good Night Dentistry In-Network?
Most medical insurance carriers typically do not contract with dentists. Therefore, the answer is no, we are not in-network.
However, our office will request a “Gap Exception” on your behalf. This means that we will ask the insurance company to agree to cover your case at “in-network” rates.
How much will my insurance cover and what will be my out of pocket costs?
Once you have a sleep test completed and a diagnosis of obstructive sleep apnea, our trained staff can help by verifying your eligibility for coverage and insurance benefits in advance of treatment. We can quickly determine if your policy covers DME, the amount of the deductible and how much has been used in the current year. We can also gather information on co-pay amounts and any secondary co-insurance.
All of this will give us a good idea of cost but please note that most medical insurance requires a pre-estimate of benefits payable before we can proceed. The patient care coordinator at Good Night Dentistry will be happy to file this for you.
Are there Payment Options available?
Yes. These will be discussed before treatment.
We do offer a discount for cash or check up front. We also accept visa, discover and Mastercard for payment. There is also third- party financing available through Care Credit.
Does Good Night Dentistry help with filing medical insurance?
Yes. We work with Nierman Practice Management, which as part of their function, acts as an experienced medical billing company. Our trained staff can file the claim for you, or if you desire, we can help you to submit a claim. If you choose to do so, use diagnosis code G47.33 (Obstructive Sleep Apnea (adult0 (pediatric)), and DME code E0486 for the oral appliance.
Is an Appliance for Snoring covered by medical insurance?
Medical insurance will generally only cover custom, titratable mandibular advancement devices. They do not cover OTC devices, and do not cover treatment for primary snoring without the diagnosis of sleep apnea.
Does Good Night Dentistry take Medicare?
For a patient to receive reimbursement from Medicare, the treating dentist must be enrolled as a Medicare DME Supplier. We are currently undergoing the application process for this.
Does Medicare cover oral appliances to treat obstructive sleep apnea?
With a sleep test and a diagnosis of obstructive sleep apnea, Medicare will cover treatment with an oral appliance.
Medicare covers specific oral appliances which they list as approved. Our office has this list, and our doctors can help to find the device that is right for you.
If you are a VA patient and can’t wear your CPAP, we can work with the VA to help you with your oral appliance coverage.