Even though oral appliance therapy is administered by a dentist, did you know that medical insurance benefits are billed for the service? It is perfectly logical to assume that dental insurance is utilized for services rendered by a dentist, but there are many services that a dentist performs, including fabricating an oral appliance for sleep apnea, that is billed to medical. This can be an advantage for a number of reasons: you probably already met your deductible if your sleep study was done in this benefit year—so in most cases the deductible would not need to be met; more people have access to medical insurance; and medical insurance maximums are significantly higher than dental insurance on average. Of course, there are always exceptions, exclusions, and the fine print of every policy.
We are happy to research your benefits and submit a preauthorization for the appliance to your insurance company. Unfortunately, no matter what your insurance determines, the preauthorization is no guarantee they will pay once the claim is formally submitted. Never hesitate to ask about your health insurance benefits as we are always happy to help!
