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Does Medicare Cover Sleep Studies?

Christian Worstell

by Christian Worstell | Published December 16, 2020 | Reviewed by John Krahnert

Medicare typically does cover sleep studies to determine whether or not you suffer from sleep apnea.

A Medicare Supplement (Medigap) plan can help pay for your sleep study Medicare costs, such as Medicare deductibles, copays, coinsurance and more.

Man asleep in his bedMedicare may cover your sleep study to determine if you suffer from sleep apnea.

How Much Do Sleep Studies Cost With Medicare?

If you show symptoms of sleep apnea and your doctor orders testing, Medicare will help pay for Type I, II, III and IV sleep studies.

  • Even if your sleep study is covered by Medicare, Medicare requires that you pay 20 percent of the Medicare-approved costs of the study.

  • Additionally, you’ll have to pay any part of your Part B deductible that you haven’t yet met. In 2019, the Part B deductible is $185 per year.

A Medicare Supplement Insurance (Medigap) plan can help pay for your sleep study Medicare out-of-pocket costs.

In most states, there are up to 10 standardized Medigap plans to choose from.

Does Medicare Cover Sleep Apnea?

Sleep apnea can be a serious health problem. It occurs when your normal breathing is interrupted during sleep. Medicare does help cover some sleep apnea tests and treatment.

Those who go untreated may wake up dozens or even hundreds of times throughout the night. Because of this, the brain, and often the rest of the body, does not get enough oxygen.

The effects of the disorder can be major. Sleep apnea can result in:

  • Higher blood pressure

  • Heart failure

  • Heart attacks

  • Stroke

  • Depression

  • Diabetes

  • Headaches

  • Worsening performance of everyday activities

If your doctor suspects you have sleep apnea, he or she may order that you undergo a polysomnography test.

  • During the test, you will be hooked up to equipment such as electrodes, which will be attached to your face and scalp. These record signals generated by your brain and muscles while you sleep.

  • You’ll be fitted with a belt around your chest and abdomen, in order to measure your breathing.

  • You’ll also receive a probe on your finger, which will measure oxygen in your blood.

Whether your sleep study uses these or other equipment, a sleep specialist will review the results of your exam, and determine whether or not you have sleep apnea.

Find Medicare Supplement Plans That Help Cover Your Sleep Study

If you undergo a sleep study that is covered by Medicare, a Medicare Supplement Insurance (Medigap) plan can help cover some of your associated Medicare costs.

For example, each of the 10 standardized Medigap plans that are available in most states provide at least partial coverage for the Medicare Part B coinsurance or copayments you might face when you undergo a covered sleep study.

Learn more about common procedures that medicare covers.

A licensed agent can help you decide on a Medicare option that works for you. Call today to speak with a licensed agent and compare the Medigap plans that are available where you live.

 

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Christian Worstell is a health care and policy writer for MedicareSupplement.com. He has written hundreds of articles helping people better understand their Medicare coverage options.

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