Medical Insurance – Northern Arizona

How Medical Insurance Works

Medical insurance coverage for sleep apnea can vary quite a bit across different plans. Here are some key points that apply to the majority.

· Sleep studies and sleep apnea treatments are covered much of the time. However, every plan is different, so some may only cover in-lab sleep tests as opposed to the in-home alternative. Some plans may only cover certain types of sleep apnea treatment. With certain plans, you may need to obtain pre-authorization from your insurance company.

· Before your insurance coverage takes effect, you might need to pay a predetermined amount out of pocket. This is called a deductible.

· You will have either a copay or a coinsurance. A copay is a fixed fee for specific services, while coinsurance is a percentage of the service cost that you are responsible for. Insurance plans usually enforce either copays or coinsurance.

Medical Insurance vs. Dental Insurance

Dr. Held specializes in dentistry, but dental insurance does not cover the sleep apnea treatment offered at his practice. Instead, dental insurance addresses oral health conditions, like tooth decay and gum disease, with the goal of preventing and treating them. Medical insurance is designed to protect the body as a whole, making it apply to those who have sleep disorders.

In-Network vs. Out-of-Network Coverage

When choosing a sleep dentist, it is key to know if they are in or out-of-network with your insurance provider. Here is what this means.

In-Network

Being in-network means that the practice has a contract regulating prices and other aspects of your treatment with the insurance company. This arrangement helps to reduce out-of-pocket costs for the patient. At Sleep Better Southwest we are happy to file with Blue Cross Blue Shield and Tricare to maximize your benefits.

Out-of-Network

If you have a different insurance provider, give us a call so we can let you know if we accept your plan. We can also discuss alternative payment options, like CareCredit, to best help your treatment fit into your budget.