Does Medicare Cover Mandibular Advancement Devices?

Though CPAP (Continuous Positive Airway Pressure) is one of the best ways to treat obstructive sleep apnea, there are also some alternatives. One popular option is the Mandibular Advancement Device.

For those over 65 who are considering one, a common question is, “does Medicare cover mandibular advancement devices?”

In this article, we answer that question in clear, plain English. You will also find the average costs of mandibular advancement devices as well as other helpful info.

Does Medicare Cover Mandibular Advancement Devices?

The short answer is yes; Medicare will cover the cost of mandibular advancement devices. But not 100% of the time.

As is often the case with Medicare, Medicare will only pay for your mandibular advancement devices under certain conditions. Below we look at what these are so you know what to expect.

Mandibular advancement devices fall into the category of Durable Medical Equipment (DME). This means Medicare will cover them under the DMEPOS benefit category. And, as you may know, DME is covered by Medicare Part B.

For Medicare to cover mandibular advancement devices, however, it must be medically necessary and must be used for treating obstructive sleep apnea (OSA).

Also, Medicare will only cover mandibular advancement devices if your dentist is a part of the Medicare program as a DMEPOS supplier.

How Much Does Mandibular Advancement Devices Cost?

The cost of mandibular advancement devices widely ranges from about $40 to as high as $2,000, depending on the type. Off-the-shelf mandibular advancement devices usually cost $75-$100, while custom-made ones are much more expensive, ranging from $1,500-$2,000.

What Is A Mandibular Advancement Device?

Mandibular advancement devices (MAD), sometimes called oral appliances, are an anti-snoring device that can help treat OSA. MAD aims to move the mandible forward to reduce any restriction in the back of the throat.

This results in an increase in the upper airway’s size, which leads to the reduction of snoring. MADs are usually fitted within your mouth and molded on your teeth to provide a platform. The platform keeps the upper jaw intact and pushes the lower jaw forward.

Though this is useful in treating OSA, you may experience discomfort while wearing one.

What Are The Types Of Mandibular, Advancement Devices?

There are 3 different types of MADs

Boil and Bite MADs
Semi-custom MADs
Custom MADs

Boil and bite MADs are off-the-shelf devices that you can buy at pharmacies and online. They are usually made of soft material like resin or silicone. When you pour hot water on them, you can easily mold them by placing them on your teeth. These are the cheapest ones, ranging from $75-$100.

Semi-custom MADs require a custom mold of your teeth. You would make this mold yourself using a kit. You then send the mold away for the MAD to be custom made. for you If it does not fit, the device can usually be returned.

Custom MADs are custom-made devices crafted by dentists or sleep specialists based on a physician’s referral. They are often a perfect fit for the users and can be refined by experts. They are the most expensive type, ranging from $1,500-$2,000.

Note: Medicare coverage changes all the time. And your specific coverage may vary from plan to plan for Medicare Advantage and Medigap plans. Always be sure to double check with your health care provider and/or Medicare insurance provider about what your plan covers and what it does not.