Are Oral Appliances Covered by Insurance?

girl looking in a mirror putting in an oral appliance

Are Oral Appliances Covered by Insurance?

At TMJ & Sleep Solutions of Alabama, we are an experienced dental sleep medicine practice led by board-certified dentist Dr. Amy Hartsfield, DMD. Our team provides effective oral appliance therapy (OAT) for patients with obstructive sleep apnea (or OSA, commonly known as sleep apnea).

If you’re considering alternatives to CPAP, you probably have questions about oral appliance therapy efficacy, cost, and insurance coverage. So, are oral appliances covered by insurance?

Are Oral Appliances Covered by Insurance?

The short of it is that insurance can cover oral appliance therapy depending on patient eligibility and other factors.

The Basics: Eligibility Requirements & Filing Claims

Because oral appliance therapy is a dental solution to a medical diagnosis, coverage falls under medical insurance. Your provider’s office will need to file a claim for reimbursement for Durable Medical Equipment (DME) through your medical insurance rather than dental insurance.

Medicare vs. Private Insurance Providers

There are Medicare-approved devices. Your specialist will show you your different options so you can make an informed decision. If a sleep medicine dentist is enrolled, they will know which treatments are covered by Medicare and discuss those options with you. TMJ & Sleep Solutions of Alabama is a Medicare DME Supplier.

Other Considerations

Your oral appliance therapy coverage and reimbursement may vary depending on your insurer, even if you meet all eligibility requirements. 

Contacting your insurance provider directly is the best way to know if you’re covered (even partially) for device therapy.

Get Started with Your Oral Appliance Therapy Journey

Whether you still need a sleep apnea diagnosis or a sleep study, or you’re looking for an alternative to CPAP, TMJ & Sleep Solutions of Alabama can help you find the right treatment and start sleeping better.

You can easily make an appointment for an initial consultation or start your treatment; please call (205) 874-9699 or contact us online. We’ll gladly answer any questions you might have about insurance coverage, cost, treatment, and more.

Thanks for reading! Learn more about oral appliance therapy for obstructive sleep apnea on our blog.