Insurance Coverage for Your Sleep Study – What You Need To Know

Written by Manny Erlich on July 7, 2014. Posted in Blog, Sleep Disorders, Uncategorized



When your doctor refers you to a sleep center to understand your snoring issues, one of your first questions you’d have would probably be related to cost. Will your insurance cover it? How much will they pay and how much will you have to pay? The answers to these questions will depend on your insurance provider, but you can take comfort in the fact that many sleep studies are covered by insurance.

What insurance covers sleep studies?

Sometimes the only way to really know what is going on with your snoring is to visit a sleep center. It may take thorough observation by specialists to get to the bottom of the problem – something that can cost a good deal of money. Fortunately, says that almost all insurance programs cover sleep studies. This includes Medicare, Medicaid and most private insurance plans.

What types of sleep studies are covered?

A typical insurance plan will cover several different types of sleep studies, depending on your doctor’s recommendation and the specific insurer. The amount you pay out of your pocket will depend on your deductible and plan. The costs can vary considerably, so it is worth considering all of your options.

The most well-known type of study is conducted in a lab. According to the LA Times, a common lab study will measure over a dozen body functions through sensors in an actual laboratory setting. The cost of this kind of study can be several thousand dollars.

There are also home studies now available that cost a few hundred dollars and may be enough for your particular circumstances. They measure far fewer variables, but they are significantly less complicated and your doctor may consider them adequate.

What should you gather for your insurance company?

The best way to know what your insurance company will need to make a decision on your sleep study is to call and ask. Every insurer is different and yours may have different requirements on what information you need to provide. However, there are some common things that most insurers will ask for:

  • Your most recent prescription from your doctor for the sleep study
  • All notes from your doctor related to your snoring and the need for a sleep study
  • Information from your doctor stating that your snoring is possibly related to further health concerns

This last bit of information is important. Most insurance companies will not cover treatment for snoring alone, as they consider it a cosmetic issue. It must be related to another health issue – like sleep apnea – to warrant coverage.


Trackback from your site.

Manny Erlich

International Foundation of Employee Benefits - Certified Employee Benefits Specialist