Doctors order sleep studies to help diagnose certain disorders in patients. If you need to undergo a sleep study, one thing that might cross your mind is how expensive the process might be. Thus, you might want to check if Medicare will cover the cost of your sleep study.
This article has all you need to know about medicare sleep studies. It will provide all the answers to your questions on whether you’ll get covered or not. You must read it all the way through to find out how much Medicare covers for sleep studies.
Let’s get started.
Does Medicare Cover Sleep Studies?
It will be vital to start by understanding whether medicare covers sleep studies. Well, the reality is that Medicare covers sleep studies when they are ordered by a doctor. This can be because they want to check for conditions like sleep apnea, narcolepsy, and parasomnia.
You and your doctor can decide where and when to do the test. You can visit their facility or have them do the test at your home. Medicare will still cover your sleep study whether it’s done at home or in a hospital. But you might wonder the extent to which you’ll be covered.
Before getting deeper into the costs, there are a few things that are worth mentioning. One is that sleep studies are covered under Medicare Part B. They are considered diagnostic tests, and therefore, the only way to qualify for them is by having your doctor order the test.
Medicare covers 80% of your sleep study costs. This means that you will have another 20% of the cost to pay. This is why it is vital to have another insurance policy in place to help you cover the rest. Secondary insurance, such as Medicaid or Medigap, can be beneficial in this situation.
Can You Use Medicare Advantage to Supplement the Costs?
You might also want to consider Medicare Advantage to supplement these costs. This can be an excellent idea because of the many benefits of Medicare Advantage. However, you first need to find the right Medicare Advantage plan in your state to get the best results.
If you stay in Texas, there are lots of options available for Medicare plans in Texas. You can consider a wide range of factors to ensure you find the best Medicare Advantage plans in Texas. A good plan will help you to easily clear the 20% balance on your treatment costs.
However, there’s a lot more to note about Medicare Advantage. It has limitations, such as the fact that you might be restricted by the plan provider on where to get treatment. For instance, they might, for instance, restrict you to seeking help from sleep centers and clinics within their network.
Thankfully, sleep studies can be done even from your home. Thus, being restricted to sleep centers in a specific region won’t be a major issue. The aim should be to ensure you get the best plan and get covered fully. USA medicare advisors can help you pick a plan.
Medicare Coverage for Sleep Studies
You might wonder what types of sleep studies are covered by Medicare. Well, there are four of them, and knowing what these types of sleep studies are will be vital. They include:
- Type I
This type of sleep study aims to help in the diagnosis of sleep apnea. It is conducted by a sleep technologist in a medical facility. It is also worth mentioning that it is covered under Medicare. Your doctor needs to order it and you will be covered up to 80% of the cost.
- Type II
This is a type of sleep test that is conducted at home. A portable monitor that has seven channels is used to conduct this test. You can get this test done with or without the help of a sleep technician. This means a doctor might not order it, but Medicare will cover the cost.
- Type III
This is another home test that you can do without the help of a technician. It uses a portable monitor that has a minimum of four channels. It aims at diagnosing obstructive sleep apnea. Medicare will also cover its costs even if you do it yourself at home.
- Type IV
There are various home sleep study tools that you can use for this study. The channels to keep an eye on when preparing for such a study are three; airflow, heart rate, and oxygen saturation. You can do it with the help of a technician or go about it alone.
Those are the various types of sleep studies that you can conduct. The good news is that all these types are covered by Medicare. All you need to do is choose the type that best fits your needs. You can have an expert help determine the best solution for your sleep issues.
How Much Medicare Coverage for a Sleep Study Cover?
We have already mentioned how much Medicare will cover for your sleep study costs. The truth is that sleep study costs can be high, making it vital to get an insurance policy to cover them. It is a great idea to have Medicare cover 80% of the total cost of getting sleep studies.
Then, you can go ahead and have a secondary insurance policy to cover the remaining costs. It would be a good idea to have a Medicare Advantage plan cover this percentage. That’s why choosing the best Medicare Advantage plan will be an excellent idea.
There is so much to note about medicare sleep studies. If you are about to undergo a sleep study, then you have a hint of what to expect in terms of medicare coverage. We have looked at the various conditions that will make you qualify for medicare sleep studies.
What’s left is to get started with your Medicare sleep study. Your doctor will need to order the test before it gets underway. As long as you meet the qualification criteria, Medicare will cover up to 80% of the cost. The remaining 20% can be covered by your secondary insurance.