Medical Insurance for Oral Appliances

Enjoy Affordable Rates for Oral Appliances

If you suffer from a sleep disorder, you need an effective treatment option. To get the solution you need, you can use your medical insurance to cover the cost of oral appliances, like those used for sleep apnea treatment in Chicago or Skokie. To lower your out-of-pocket expense, it is best to understand how to make the most of your insurance policy. At Dental Professionals, we work on your behalf with your insurance company to keep your treatment affordable.

How Can I Use My Medical Insurance?

Oral appliances now play a vital role in protecting general health and improving the quality of life for those who have certain disorders, like sleep apnea. As a result, most medical plans now offer coverage for custom-made oral devices.

For your insurance to cover the treatment, they require the necessary documentation and paperwork, such as a copy of your sleep study or your sleepiness questionnaire scores. They will also ask to see clinical notes from your screening appointments to accept an order for a prescription for the oral appliance. You may be required to sign a “Proof of Delivery” form as well.

We understand this can seem like an overwhelming process. We work with your insurance company to file the necessary claims and paperwork.

How Much Will My Insurance Pay?

Depending on your specific policy, your insurance carrier may cover all or part of the cost of the treatment. To determine how much you can expect to pay before committing to an oral appliance, it is best to call your eligibility and benefits department for a predetermination. In most cases, if the proper paperwork has been filled, your oral appliance will be approved for coverage because it is classified as Durable Medical Equipment (DME), which falls into the same category as wheelchairs, walkers, and electrical stimulators for pain.

During your verification process, it is best to ask about:

  • Your deductible amount.
  • If your yearly deductible has been met.
  • Your co-payments.
  • Any preauthorization requirements.
  • If there is a GAP exception for out-of-network providers.

To make the most of your coverage, it is best to choose a sleep specialist who is in your insurance’s network; however, you can still use your insurance for those who are not. Dr. Schwartz works with both in-network and out-of-network patients to lower the amount you need to pay out-of-pocket.

Which Oral Appliances are Covered?

Currently, there are over 100 FDA-approved oral appliances. Your insurance carrier most likely will not cover them all. Instead, they will have a preferred list of manufacturers or brands that are covered under your policy. We will help you find the right one to meet your needs while also abiding by your insurance requirements.

Sleep Soundly Tonight!

If you need an oral appliance to treat obstructive sleep apnea in Chicago or Skokie, we will work with your insurance company to keep the treatment affordable. If you have any questions about your benefits, a member of your team has the answers you need. Contact our Chicago office or Skokie office today to learn more.