Insurance Coverage: Why Work With Us
"Using Your Insurance Benefits" vs. "Obtaining In-Network Coverage"
Oral Appliances for Sleep Apnea are covered by almost all medical insurance plans, including Medicare (this is a medical problem, so it is not covered under your dental plan).
Many dental providers offer verification of benefits and file oral appliance therapy claims as a courtesy to their patients. However, in most cases these are "out-of-network benefits", which mean significantly higher deductibles to meet, higher co-insurance fees and balance billing the patient for the difference, typically adding up to well over a thousand dollars in out-of-pocket costs (see here for explanations). In many cases, the treatment offered does not include follow-up sleep studies to prove efficacy - which often results in sub-optimal results, or leaves patients responsible for additional out of pocket costs.
As a dedicated dental sleep medicine practice, we strive to make this life-saving treatment as affordable as possible to all our patients - which is why we accept assignment and spend considerable effort on securing in-network coverage whenever possible, maximizing your insurance benefits and working within the allowable limits of your insurance plan - no balance billing, no surprise fees, no charges for follow-up visits and no paperwork hassles for our patients. Typical OOP costs for most of our patients range between 0 and $360 for the entire treatment, which includes titration home sleep studies to objectively determine the optimal setting of the oral device, maximizing your treatment efficacy.
We accept Medicare assignment, Blue Cross, Kaiser Permanente, Tricare, First Choice, Aetna, Cigna, Asuris and other insurance plans.
We use a third party medical billing service specializing in dental sleep medicine so that we can stay current with any changes in regulations and policies, provide efficient claims processing and do our best to minimize your out of pocket costs - all while providing top-of-the-line dental devices and the most rigorous calibration protocol available.