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Will Insurance Cover an Oral Appliance for Sleep Apnea?

·By Dr. Argyle

It's one of the first questions people ask, and a fair one. Here's the straight answer: oral appliances for sleep apnea are generally a medical benefit, not a dental one. Our sleep program is fee-for-service — you pay us directly — but we make pursuing reimbursement easy by preparing a complete, ready-to-file superbill you submit to your medical insurer.

Why it's a medical benefit

Sleep apnea is a medical condition, so treatment for it — including an oral appliance — typically falls under medical insurance rather than dental. That surprises some people who assume anything involving a dentist is "dental."

How our payment works

We keep it simple: our sleep program is fee-for-service, with custom oral appliance therapy starting around $4,500 depending on your needs. You pay us directly, and we hand you a complete superbill — a ready-to-file claim packet with everything your medical insurer needs — so you can submit it for possible reimbursement. Whether and how much you're reimbursed depends on your individual medical plan.

Why fee-for-service

Going fee-for-service keeps things straightforward and affordable, without the delays and uncertainty that can come with insurance pre-authorizations. You know your investment up front, and we make the paperwork for reimbursement as painless as possible.

Checking your medical benefits

If you want to know what your plan might cover, call your medical insurer and ask specifically about coverage for oral appliance therapy for obstructive sleep apnea, whether it's treated as durable medical equipment, and how your deductible applies. We're glad to help you understand the superbill so you can submit it with confidence.

Want to understand the cost and the superbill process for your situation? Book a consultation at Old Betsy Dental Sleep Medicine in Keene — and here's what to expect at that visit. Book online or call our team.


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