Are CPAPs and Sleep Studies Covered?
Does your insurance plan cover sleep studies or CPAPs?
Not every Marketplace plan (aka Obamacare or ACA) will cover sleep studies and CPAP machines, so if you need those covered, make sure you're on the right plan! If you're not sure about your coverage, contact one of our agents.
For ALL plans that cover Sleep Studies and/or CPAP machines, you MUST have a pre-authorization in order to get coverage.
You can get pre-authorization from your primary care doctor. They are aware that your insurance will need pre-authorization and can help you get everything you need.
It is also important to note that if your plan has a deductible, the coverage will begin AFTER you have paid the deductible.
The following Marketplace plans have coverage for Sleep Studies AND CPAP machines:
SelectHealth Silver 2500
SelectHealth Expanded Bronze 5900
SelectHealth Expanded Bronze 6900
SelectHealth Expanded Bronze 7800
SelectHealth Expanded Bronze 8700
SelectHealth Gold 1500
ALL Molina Silver plans
The following Marketplace plans have coverage for Sleep Studies only:
ALL Bright Health plans (when deemed medically necessary, which is different from a pre-authorization)
Medicare Coverage for Sleep Studies and CPAPs
Most Medicare Advantage plans provide coverage for sleep studies and CPAPs. Check with your local agent if you are unsure if your Medicare Advantage plan provide such coverage.
Let us know if you have any questions. We're here to help!
Call or text your local agent at 801-609-8699, or schedule an appointment through the link below.
About Utah Avenue Insurance
Utah Avenue Insurance is your local health insurance experts. Our agents are here to help you with all your health insurance questions. Utah Avenue can help you with marketplace (aka Obamacare) plans, private health insurance and Medicare. If you have questions about how your medical insurance plans work or need help enrolling in a plan, we can help you. As always, our service is free to you.
Give Utah Avenue a call or make an appointment with Utah Avenue Insurance and we'll be happy to help!