A diagnosis of sleep apnea can cause a life insurance company to refuse coverage. Even if you are approved for coverage, the insurer may charge you a higher rate because of the limited coverage.
However, there is some good news. According to certain insurance brokers, depending on your medical condition and how you handle it, you can get fair coverage.
According to Ed Hinerman of the Hinerman Group, which specializes in impaired risk life insurance underwriting, a lot depends on the severity of the sleep apnea mild, moderate, or severe and compliance with treatment.
One effective treatment is the use of continuous positive airway pressure (CPAP), which uses a mask and air pump to supply airflow during breath inhalation to prevent collapse of the airway.
According to Hinerman, people with a mild to moderate condition and no additional risk factors who are treated effectively, such as with CPAP, would not be charged a surcharge for an existing medical condition and would be considered for preferred plus categorization by some insurers.
When you seek life insurance estimates, your “risk class” will play a role in determining your prices. The “underwriting guidelines” of an insurance define this. (The other pricing criteria are the quantity and length of your coverage.) The lower your premiums, the better your risk class. If you are classified as “preferred plus,” you will pay less than if you are classified as “preferred” or “standard.”
A serious condition with good compliance and no other risk factors may be preferable to standard rates. According to Hineman, your ranking is determined by the severity of your sleep study findings.
Treatment is the key. The payoff for managing the disease isn’t just in terms of your health, but also in terms of your cash. If you’re not compliant, like as not utilizing a CPAP equipment after being prescribed one, your premiums could double, triple, or even quadruple. (See: Will a health problem ruin your life insurance options?)
Your life insurer will want to look over your sleep study test, which is most likely covered by your health insurance. Some life insurance companies will not consider you for a policy unless you have completed a sleep study, even if your medical records indicate that you should. The exam reveals, among other things, breathing patterns, chest muscle activity, and oxygenation.
Factors like your age at the time of diagnosis, what you’re doing for treatment, your blood pressure rate, your weight, whether you smoke or not, and any other health concerns you may have are also on insurers’ minds.
Weight loss, avoiding stimulants and alcohol before night, avoiding sleeping on your back, and using CPAP or bilevel positive airway pressure are all options for treatment (BiPAP). If you use a CPAP or BiPAP machine, you’ll get the best results if you use it every night for several hours. There are other surgical alternatives available, such as changing the shape of the jaw or tongue.
Is it hard to get life insurance with 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.
Can you get life insurance with a CPAP machine?
The sole side effect of sleep apnea is a fatigued partner who is awake all night due to your snoring.
Sleep apnea is a chronic condition in which breathing stops and begins periodically during sleep. Carbon dioxide builds up in the bloodstream when breathing is stopped. The brain is then told to rouse the sleeping individual and breathe in air, thanks to a receptor in the circulation.
Breathing regularly again restores oxygen levels, and the person falls asleep again. It’s uncommon for the person to even notice they’re having trouble breathing.
If left untreated, sleep apnea can cause hypertension, cardiac difficulties, lung damage, a lack of attention, and an increased risk of car accidents. Because of these possibilities, the life insurance market scrutinizes candidates who suffer from sleep apnea.
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!
Does sleep apnea shorten life span?
Sleep apnea is harmful because it causes high blood pressure and is linked to an increased risk of heart attack, irregular heart rhythms, and heart failure if left untreated. Sleep apnea has been proven in studies to reduce life expectancy by several years. In addition, patients with untreated sleep apnea have difficulty focusing, concentrating, and organizing their thoughts. Furthermore, due to decreased attention, sleep apnea has been related to an increased risk of motor vehicle accidents.
Regardless of how long they slept, many sleep apnea patients report waking up with morning headaches, dry mouth, lethargy, or a feeling of drowsiness.
Is sleep apnea covered?
Most insurance coverage cover CPAP since it is the most prevalent kind of sleep apnea therapy. According to Dr., CPAP is “considered to be durable medical equipment.”
Why would my insurance 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.
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. If you have any symptoms of these disorders, including sensitivity to light, cloudy vision, acute eye pain, nausea or halos surrounding lights, you should consult your doctor. 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.
Does sleep apnea affect travel insurance?
“Our opinions on OSA assessment are really straightforward. Obstructive sleep apnoea is a little risk for travel insurance. In our opinion, if you have been instructed to use CPAP and follow through with it, you are highly unlikely to acquire OSA issues.
What comes with a CPAP machine?
Components of CPAP Air filters remove dust and pet dander from the air entering your machine; a humidifier tub holds the water for your humidifier; and air tubing links your CPAP machine to your mask.
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.