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Health insurance coverage for sleep studies

Medicare, as well as most insurance companies, will provide payment for a medically-indicated sleep study. While sleep studies have traditionally been performed in a sleep lab during an overnight stay, Medicare and many other insurance companies now also pay for in-home sleep studies used to diagnose Obstructive Sleep Apnea (OSA).

It is important to contact your insurance company to determine if they will be paying for an in-lab or in-home sleep study and to understand any deductible or co-payment amounts that will be your responsibility to pay.

health insurance

Health insurance coverage for sleep therapy

Medicare and most other insurance companies will pay for a CPAP or bi-level device and related accessories and supplies, provided that specific coverage criteria are met. Coverage criteria is documented by, but is not limited to, the following:

  • Qualifying sleep study
  • Diagnosis of OSA
  • Prescription from your treating physician detailing needed equipment and supplies
  • Physician chart notes

Your insurance company and your durable medical equipment (DME) supplier will be able to assist you in understanding what is covered, what documentation is required, and any financial responsibility you may have, such as deductibles or co-payments.

Learn more about starting treatment for sleep apnea.