A pre-existing condition is a health issue that you had prior to the start date of your new health coverage. Pre-existing conditions include epilepsy, cancer, diabetes, lupus, sleep apnea, and pregnancy.
How many years does sleep apnea Take off your life?
Obstructive Sleep Apnea (OSA) is the more common of the two types of sleep apnea. While sleeping, your airway becomes physically closed or collapses, resulting in snoring, which is one of the most prominent symptoms of sleep apnea. However, this snore is frequently overlooked, leading to the misdiagnosis of sleep apnea. This is risky, because undetected obstructive sleep apnea can shorten your life and cause a slew of health issues.
Because OSA limits the quantity of oxygen your lungs can take in when you sleep, it has a variety of negative consequences for your health. Reduced oxygen intake has a significant impact on your cognitive function, increasing your chances of being involved in a work or driving-related mishap. A lack of oxygen also raises your risks of having a heart attack, and OSA is directly responsible for roughly 80% of all nocturnal strokes. Obstructive sleep apnea, if left untreated, can reduce your life expectancy by 12-15 years.
While there is no permanent cure for obstructive sleep apnea, effective diagnosis and treatment are required to reduce its symptoms and guarantee that OSA does not shorten your life.
The first step in properly treating your OSA is to get a proper diagnosis, and the skilled staff at Hudson Valley Sleep Solutions is ready to help you figure out what’s causing your sleep problems. The strength and severity of your sleep apnea can be determined in as little as a few days, and a proper treatment plan can be devised. Our team has completed extensive training with Sleep Group Solutions, allowing us to build a customized treatment plan that will help you manage your OSA the most effectively.
There are a variety of effective treatment options depending on the severity of your OSA. Treatment for mild to moderate cases can range from simple lifestyle adjustments to a variety of oral or breathing devices used while sleeping. Even if your situation is too serious for our staff to handle, we will never hesitate to refer you to the appropriate physician or expert so that you can get the finest care possible.
Don’t put up with the snoring any longer; contact Hudson Valley Sleep Solutions today to schedule your free consultation!
Is sleep apnea a permanent disability?
Sleep apnea is no longer listed as a disability by the Social Security Administration (SSA), but it does include entries for respiratory disorders, cardiac problems, and mental deficiencies. You would immediately qualify for disability benefits if you match the criteria of one of the categories owing to your sleep apnea. Severe cognitive deficits, mental abnormalities, and/or behavioral disorders; chronic pulmonary hypertension; or chronic heart failure/cor pulmonale are some of the methods to fulfill the standards for consequences caused by sleep apnea (right-sided heart failure).
Chronic pulmonary hypertension can automatically qualify for disability payments if the mean pulmonary artery pressure is equal to or greater than 40 mm Hg, according to Listing 3.09. (as determined by cardiac catheterization while medically stable). Listing 4.02 outlines the criteria for when chronic heart failure qualifies for disability, while listing 12.02, which includes organic mental diseases, discusses the criteria for when mental conditions such as intellectual challenges, memory problems, depression, and/or anxiety qualify for disability. To be eligible for benefits under this category, you must be able to demonstrate that you have:
- a loss of intellectual ability of at least 15 I.Q. points, memory problems, or thinking disorders, such as hallucinations or time or place disorientation, that causes limitations in everyday activities, concentration or pacing problems, or social functioning problems
- Personality changes associated with mood swings or other mood disturbances such as depression, explosive temper, or impulsivity that limit your activities, make it difficult to get along with others, make it difficult to focus and complete tasks, or cause recurrent periods of decompensation (worsening), or
- a long-term biological mental illness that has hampered your capacity to do basic employment tasks. You must be on medication or receiving psychosocial support, and you must have had repeated, long-term episodes of decompensation (or evidence that even a small increase in demands will likely cause you to decompensate) or an inability to function outside of a supportive living environment for at least one year (with evidence you will continue to need that environment).
The majority of people with sleep apnea will not qualify for disability under one of the above-mentioned categories, but there is another option.
Can you be denied life insurance for sleep apnea?
Does sleep apnea make you ineligible for life insurance? Sleep apnea does not automatically rule you out of getting life insurance. You may receive higher prices, but if you’re treating your ailment and otherwise appearing to be in better or increasing health, you might not have to spend much more.
Do you have to declare sleep apnea to car insurance?
It goes without saying that falling asleep or fainting while driving is extremely dangerous for you and other road users.
According to the Sleep Apnea Trust, if your sleep apnea is mild or moderate and you don’t experience extreme tiredness, you don’t need to tell the DVLA or your insurance provider. They must be told, though, if you are extremely sleepy.
If you have frequent fainting spells, it’s critical that you contact your auto insurance company if they occur while you’re driving.
Visual impairments
Your eyesight can decrease as you get older, which is why it’s critical to have frequent eye exams. During your driving test, you may recall the examiner asking you to read the number plate of the automobile in front of you. This easy task allows them to check your eyesight and make sure you can see everything well around you. If you were wearing glasses or contact lenses throughout the test, you must continue to wear them whenever you drive in the future.
The DVLA and your insurance provider must be contacted if your vision deteriorates, you experience double vision, or you lose your eyesight completely. Cataracts, glaucoma, and night blindness are among problems that can deteriorate as people become older. You should visit your doctor if you have any of these symptoms, such as light sensitivity, cloudy vision, acute eye pain, nausea, or halos surrounding lights. They may advise you to refrain from driving until you get your eyesight checked, so see if you can arrange for someone else to accompany you to the appointment.
History of strokes
You should be able to drive normally as long as you haven’t had a stroke recently. If you have a stroke, you won’t be able to drive for a month and will need to notify your insurance company and the DVLA. Your doctor will assess whether it is safe for you to drive again after 30 days, but your insurance rate may rise.
Epilepsy
It’s difficult to predict when an epileptic fit will occur, just as it is with sleep apnea or fainting. If you have epilepsy, the DVLA will most likely want to meet with you in person to assess how severe your condition is and whether you can continue to drive safely.
It’s possible that your license will need to be renewed every three years rather than every ten, and if you have a seizure, you should see a doctor as soon as possible and contact your vehicle insurance carrier.
Neurological conditions
Parkinson’s disease, narcolepsy, multiple sclerosis, motor neuron disease, and Alzheimer’s disease are all neurological disorders. If you have one of the above, you will need to be evaluated and your license may need to be renewed every year. You may need to be evaluated on a regular basis if you have an illness that can worsen with time, such as Alzheimer’s disease or motor neuron disease.
Physical impairments
Your auto insurer must be notified if you have a physical impairment, such as an amputated leg or a spine problem, especially if your vehicle has been customized specifically for you.
You may need an automobile with hand controls instead of pedals, steering aids, electronic accelerators, or a ramp if you have a physical disability. These modifications may raise your auto insurance premiums, and if you don’t reveal them, your policy may become void if you need to file a claim.
If you require a courtesy car, it’s also a good idea to check with your insurance provider. Do they have an appropriate alternative vehicle that you can drive?
Does diabetes affect car insurance?
If you can simply control your diabetes, it shouldn’t affect your vehicle insurance. You will be awarded a limited license if you require treatment, such as insulin. These can only be used for one, two, or three years. If you have a restricted license, you may be regarded a riskier driver, and your premium may be affected.
You can utilize the government’s A-Z check to see if your health condition needs to be declared. If you need to notify the DVLA, you’ll need to find the right form. There are several forms to choose from, and your condition will dictate which one you should choose. The FEP1 form, for example, is for people who are having convulsions, seizures, fits, deja vu, blackouts, or fainting. Use the A-Z list above to find your ailment, then click on it to find out which form you need to fill out and a link to it. You can also report your condition via the internet. Give your insurance provider a phone or send them an email to let them know about the problems.
Why would my insurance company deny a sleep study?
Is it true that sleep studies are covered by insurance? The short answer is YES; practically all insurance companies fund sleep testing. Some insurance plans, however, have different regulations about sleep studies than others. Some insurance policies, for example, will demand a Home Sleep Test (HST) before they will fund an in-lab test (PSG). Because HSTs can accurately diagnose 75 percent of individuals with sleep apnea who have been thoroughly screened by a physician, ordering the more expensive (but more accurate) PSG scan isn’t always necessary.
Important insurance jargon to be familiar with
Some of the misconception about how much a patient must pay for services originates from a misinterpretation of language used by insurance companies in their policies. We’ll try to explain these often-confusing terminology that characterize your policy in this section.
In-network.
When arranging a sleep study with a clinic, one of the most important things to look for is whether or not your insurance provider is “in-network” with the clinic. When a clinic is in-network with your insurance provider, it indicates the two parties have agreed on a lower pricing for treatments. For example, our basic charge for a CPAP titration is $4,000 (before physician expenses), however that rate is substantially reduced for insurance carriers with which we are in-network. We’re in-network with a particular company, and the fee is $2700, a savings of $1300 over the initial amount.
This implies that if we are in-network with your insurance, your insurer will pay a lower pre-determined cost for our services, and you will spend less of your own money. If the clinic you’re going to is out-of-network, they’ll either have to pay a higher rate, they’ll only agree to pay a set amount, leaving you to pay extra, or they’ll refuse to pay the entire cost, leaving you to foot the price.
Check with your insurance to see which clinics are in-network before scheduling a sleep study so you don’t end up with a bigger fee.
Deductible
Your deductible is the amount you must pay each year before your insurance will pay for any services.
Let’s say you come to our clinic for a titration study and your insurance plan’s in-network fee is $2700, but your deductible is $1000 and you haven’t had any other services this year. Before your insurance begins to cover anything, you will normally have to pay $1000 out of pocket. This isn’t even a guarantee that your insurance will cover the remaining $1700. The amount they pay for the rest is also determined by your coinsurance.
Coinsurance
Your coinsurance is the portion of the cost of a health-care service that you share. It’s commonly calculated as a percentage of the overall service fee. After you’ve paid your deductible, you’ll start paying coinsurance.
Let’s get back to that $1700 cost once you’ve reached your deductible. A standard coinsurance percentage is 20%, which means your insurance will cover 80% of the cost and you will cover 20% of the remaining $1700. Your insurance will cover $1,360, while you will be responsible for $340. When you factor in the deductible, the total cost of treatments in this instance is $1,340.
Copay
A copay is a set amount you pay for a health-care treatment at the time you receive it. The majority of copays are for filling medications and only rarely for services like sleep studies, however your insurer may require you to pay a small upfront amount at the time of service. Depending on the type of service, the amount may differ.
Out-of-pocket
The maximum amount you will spend out of pocket for approved medical expenses in a particular year is known as out-of-pocket.
Many insurance plans will require you to meet a deductible before moving on to a coinsurance percentage that you will be responsible for up to a certain amount. Once you’ve reached that amount and paid your maximum out-of-pocket limit, your insurance will normally start paying for 100% of the charges.
While having a sleep study done at the beginning of the year may cost you some money, once you’ve met your out-of-pocket fees, your insurance will usually cover the balance of the services. These costs could include your CPAP machines, masks, hoses, and other therapy-related durable medical equipment (DME).
It’s also important to make sure that when the year draws to a close and you’ve paid off all of your out-of-pocket expenses, you’re up to date on all of your DME equipment so that your insurance will cover it, rather than having to pay for it yourself at the start of the next calendar year.
What if you don’t have insurance?
We never turn anyone away who is suffering from a sleep condition at The Alaska Sleep Clinic, regardless of whether or not they have insurance. We will always work with patients to find solutions to cover services.
We also provide a 20% discount on all cash-pay services if you pay with cash. We think that a person’s financial condition should never prevent them from getting treatment for debilitating sleep disorders, and we are happy to work out payment plans with them.
Questions to ask your insurance company and other considerations
Learn everything you can about your policy. This entails being aware of your premiums, covered services, deductibles, coinsurance, copays, and out-of-pocket costs.
If your primary care physician refers you to a clinic, double-check that the clinic is in your insurance’s network.
An insurance company will refuse to pay for a sleep study if they believe it is medically unnecessary. Your doctor may recommend a research, but your insurance company may object. Because a PSG is not medically essential, your insurance company may consent to a HST. Once your HST has been examined by a sleep specialist and it has been determined that a PSG is medically necessary, your insurance company may agree to cover the cost of the procedure. If you do the PSG first, they may refuse to pay the charges.
Insurance companies follow extremely strict guidelines for sleep studies, taking into account comorbidities and previous medical history. If you’re not sure if you’re covered, call your insurance provider and find out what you need to do to submit a study pre-determination request.
We undertake insurance verification as a convenience to patients at The Alaska Sleep Clinic in order to prepare a price quote. This price quote, however, is only an estimate of your payment part and not a firm amount that you will pay.
If you’re ready to arrange a sleep study and have checked with your insurance provider about your coverage options, contact The Alaska Sleep Clinic to set up an appointment, and we’ll help you get started on treating your sleep condition.
Is sleep apnea fatal?
Although a person with sleep apnea does not always die while sleeping, the chance of death rises dramatically if the condition is left untreated. When the brain detects a lack of oxygen, it tells the body to wake up, which is why patients with sleep apnea do not frequently die in their sleep.
Does sleep apnea get worse with age?
Aging. Finally, aging can exacerbate sleep apnea. You may lose muscle tone in your airway in the same manner that you lose muscle tone in your arms and legs. This could jeopardize its ability to remain open.
What can happen if sleep apnea goes untreated?
Sleep apnea can lead to a variety of health issues, including hypertension, stroke, arrhythmias, cardiomyopathy (enlargement of the heart muscle tissue), heart failure, diabetes, obesity, and heart attacks if left untreated.
Because sleep apnea is associated with high blood pressure, it’s likely that it can lead to arrhythmias and heart failure. Sleep apnea affects roughly half of all persons with heart failure or atrial fibrillation.
Due to the high occurrence of sleep apnea in cardiac arrhythmias and heart failure (it’s virtually a coin flip whether the patient has it), doctors advise that you seek medical help as soon as possible.
Is sleep apnea a military disability?
Once a veteran can show that their sleep issue is related to their military service, the VA will calculate their monthly compensation based on a complicated set of grading criteria outlined in VA regulations.
Obstructive sleep apnea is the most frequent sleep issue we find in veterans. Sleep apnea is graded on a scale of 0, 30, 50, or 100 percent disability.
If the veteran has sleep apnea but no other symptoms, the veteran will be given a 0% rating, which means he or she would not get any monthly payment for sleep apnea.
If the veteran is very sleepy during the day, he or she will be given a 30 percent grade.
A veteran who uses a continuous positive airway pressure (CPAP) device will receive an automatic 50% rating.
Finally, a 100 percent rating will be given if the veteran’s sleep apnea causes persistent respiratory failure with carbon dioxide retention or cor pulmonale, or if their sleep apnea necessitates tracheostomy.