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does medicare cover mouth guards for sleep apnea

Does Medicare Cover Sleep Apnea Oral Appliances?

Snoring may sound normal to you and a lot of people. But did you know that it could be a sign of obstructive sleep apnea or OSA?

One of the ways to treat OSA is through the use of certain oral appliances. If you’re looking into one of these devices, a common question is “Does Medicare cover sleep apnea oral appliances?”

In this article, we answer this question in clear, plain English. You will also find the average costs of sleep apnea oral appliances and other helpful info.

Does Medicare Cover Sleep Apnea Oral Appliances?

The short answer is yes; Medicare will cover the cost of sleep apnea oral appliances. But not 100% of the time. As is often the case with Medicare, certain conditions have to be met in order for Medicare to pay for your sleep apnea oral appliances. Below we look at what these are so you know what to expect.

Oral appliances are considered as Durable Medical Equipment (DME). Medicare Part B provides coverage for DME. However, before Medicare Part B covers oral appliances for sleep apnea, your dentist/supplier must be enrolled in Medicare. Once all requirements are met, Medicare Part B will pay 80% of the oral appliance’s cost.

Medicare Advantage plans (Medicare Part C) also provide coverage for oral devices for treating sleep apnea. They cover everything Original Medicare covers along with some additional benefits.

How Much Does Oral Appliances Cost?

Oral appliances used for sleep apnea, along with dentist visits, adjustments, and follow-ups, usually cost between $1,800 to $2,000.

What Is An Oral Appliance?

Oral appliances are helpful for treating OSA as well as its symptoms. They are a good alternative to CPAP machines.

Oral appliances work in treating OSA by moving the jaw forward, preventing the tongue from blocking the throat. When the jaw shifts forward, it increases the size of the upper airway.

Once the size of the upper airway increases, the air resistance which causes snoring will be reduced. Most of the time oral appliances are used to treat mild to moderate sleep apnea cases. However, they can also be used to treat OSA if the patient is having difficulty tolerating CPAP or cannot tolerate it at all.

What Is Obstructive Sleep Apnea?

Obstructive Sleep Apnea, or OSA, is a sleep disorder that causes the patient’s breathing to stop and start as he/she sleeps. OSA is the most common sleep apnea.

OSA occurs when the throat muscles periodically relax and block the airway as the person sleeps. The most common symptom for OSA is snoring.

What Are The Symptoms Of OSA?

A person who suffers from OSA is usually who discovers that they have it. Often it’s their partners or someone else who may observe them sleeping. Common symptoms of OSA may include:

  • Snoring
  • Sleepiness or fatigue while awake
  • Feelings of restlessness while asleep
  • Having a dry mouth or sore throat after waking up
  • Easily irritated
  • Forgetfulness
  • Having difficulty concentrating

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.

Additional Info on Medicare Coverage

This article is part of our series on “What does Medicare cover?”

Also, you can check out other articles in this series including: Does Medicare cover intermittent catheters?

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