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Is Sleep Apnea Covered By Insurance In India

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Your Breathing And Sleep Challenges May Not Be What You Think

VA Disability for Sleep Apnea | What Sleep Apnea symptoms to look for in your records | theSITREP

Studies have shown that in up to 98 percent of patients with OSA, the sleep disorder is caused by abnormal anatomical featuresmost notably, an underdeveloped mouth and jaw.

While an underdeveloped jaw may seem like an inconsequential cosmetic issue, the truth is that it could be the root cause of OSA, a serious sleep disorder that is associated with a number of chronic, life-threatening health concerns.

How Many Hours Per Night Should Cpap Be Used

CPAP is unquestionably the most successful treatment available for sleep apnea. Unfortunately average use of CPAP is only 4-5 hours/night, not the recommended 7 1/2 hours a night. This can lead to deadly consequences for many reasons. The 25% of patients who wear their CPAP all night every night are not at risk.

Questions To Ask Your Insurance Company And Other Considerations

  • Learn as much about your policy as possible. This means knowing your premiums, services that are covered, deductibles, coinsurance, copays, and out-of-pocket expenses.

  • If your primary care physician refers you to a clinic, check to make sure that the clinic is in-network with your insurance.

  • Find out if your out-of-pocket expenses include your deductible.

  • The main reason an insurance company would reject paying for a sleep study is if they deem it medically unnecessary. Your doctor may say you need a study, but your insurance may disagree. Your insurance may agree to have an HST because they believe a PSG not to be medically necessary. Once the HST has been reviewed by a sleep professional and it has been found that a PSG is medically necessary, your insurance may then agree to pay for a PSG. However, if you do the PSG first, they may not agree to pay charges.

  • Insurances have very specific guidelines they follow for sleep studies, and they take into account comorbidities and all past medical history. If you are uncertain about coverage, call your insurance company and ask what you need to do for a pre-determination request for a study.

  • At The Alaska Sleep Clinic, we do insurance verification as a courtesy to patients to draft up a price quote. However, this price quote is simply an estimate of your portion of the payments and not a definitive price that you will pay.

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When To Call A Doctor

  • You or your bed partner snores loudly and heavily and feels sleepy during the day.
  • You notice that your bed partner stops breathing, gasps, or chokes during sleep.
  • You sometimes fall asleep at the wrong times, such as while you are talking or eating. Do not drive when you are drowsy.
  • Your child snores, has trouble breathing while sleeping, sleeps restlessly, wakes up often, or is very sleepy during the day.

How Sleep Apnea Affects Health Classifications

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The severity of your condition and other factors, including your height-to-weight ratio and oxygen saturation levels, will determine the health classification youre assigned during your life insurance application. Your health classification, in turn, affects your cost of life insurance.

Each insurer weighs these health factors differently. The best way to find a provider that will offer you the most affordable policy for your personal situation is to work with an independent broker. At Policygenius, our experts are licensed in all 50 states and can walk you through the entire life insurance buying process while offering transparent, unbiased advice.

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Regulations In Issuing Driving License

Sleep-related breathing disorders are one of the major causes of daytime sleepiness in a sober person. Recent research has concluded that about 9.5% of car crashes are due to drowsy driving. Although sleep apnea was recognized in the latter half of the 21st century, legal battles pertaining to sleepy driving were filed as early as 1925. A multitude of similar cases has emerged since then leading to stringent laws against drowsy driving. In the USA, Maggies law and Arkansas Act 1296 deems drowsy driving as a criminal liability and is regarded as equivalent to vehicular homicide.4 Some states in the USA have made it mandatory for the applicants to notify the licensing authorities regarding their OSA status. On a similar note, the European Union Directive on Driving Licenses was revised in 2014 where the applicants are to undergo a formal examination if they are suspected to be suffering from OSA. Once the diagnosis is established the licenses are issued or renewed only after substantiation of treatment controlling OSA symptoms.5 In the UK, failure to notify daytime sleepiness, irrespective of the severity of OSA can entitle a fine of up to £1,000.6 Also, in some countries, presence of uncontrolled OSA impacts car insurance, and the collision coverage will be significantly reduced.7

What Is The Cost Of Orthognathic Surgery

Every procedure needs different implants, time, technique, anesthesia, and post-operative care. Depending upon the cost of the implant and other factors surgery costs will vary widely from thousands to lakhs. Jaw surgeries done under local anesthesia is quite cheaper than that done under general anesthesia.

All you must do is to book an appointment with the right plastic surgeon for evaluation.

Achieving perfection in anything requires time, effort, and expenditure. In the case of our face and bodies, however, the effort is not entirely sufficient to achieve what we have always desired, surgeons would also require good knowledge, experience, and aesthetic sense. In such situations, corrective jaw surgery can be a worthwhile investment and allow us to attain the looks we have always wanted. Orthognathic surgery is one such restorative procedure that can sculpt your jaws and give you the cheekbones of your dreams.

We, at Richardsons Hospital, are committed to providing you the absolute best quality of care during your jaw surgery in India. Our leading surgeon, Dr. Sunil Richardson is the best maxillofacial surgeon in India, who has operated over 10000 faces with 100 percent results and patient satisfaction. We have the latest surgical equipment and highly trained and specialized staff who use the latest techniques to give you your dream look.

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Treating Sleep Apnea In Children

Enlarged tonsils or adenoids are a common cause of sleep apnea in children, so surgery to remove them is usually the first treatment. Children may also be treated with CPAP or corticosteroid medicine. In some cases, a dental device that widens the mouth can help. Children who are overweight are encouraged to lose weight.

What Are Some Of Those Requirements Lets Take A Closer Look

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  • You may need prior authorization to receive your CPAP machine check first.
  • You will need to have a face-to-face appointment with a physician or sleep doctor, and you will need this every year for most insurance and Medicare.
  • You will also be required to stay compliant proving that you are using your device at least 4 hours a night for continuing insurance coverage.
  • After seeing your doctor, you will be required to take a sleep study, and you may have to do that in a sleep lab environment rather than taking the simple at-home sleep study.
  • You will probably need to meet certain criteria and have an AHI between 5-14 with such comorbidities as hypertension. Your sleep study will determine your AHI

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Study Setting And Population

The population for this cross-sectional study was consecutive patients in whom OSA was diagnosed in the authors’ sleep laboratory from June 2015 to August 2016. This sleep laboratory is the only level 1 polysomnography laboratory in central India. The laboratory caters to referred patients as well as walk-in patients. Patients with OSA who were older than 18 years of age, with an apnea-hypopnea index > 15 , and were advised to use CPAP therapy were included. In this sleep laboratory, patients with mild OSA are not advised to use CPAP therapy. Patients who did not give consent to be a part of the study were excluded.

Medicare Coverage For Sleep Apnea

Many people experience obstructive sleep apnea and the condition may lead to a variety of health complications down the line. Medicare Part B insurance may be able to help you cover the costs of CPAP therapy. Finding and staying consistent with your CPAP therapy can reduce your health risks and improve your overall health quality over time.

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Can You Qualify For Life Insurance If You Have Sleep Apnea

Yes, you can qualify for life insurance coverage if you have been diagnosed with sleep apnea as long as youre being actively treated for this condition. However, the severity of your sleep apnea and other factors, including your height-to-weight ratio, may also have an impact on your application. Youre more likely to get lower rates if your sleep apnea is mild and you stick to a treatment regimen.

Here Are A Few Questions To Ask Your Provider:

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  • May I purchase the CPAP machine and still have it covered?
  • Is Respshop in network or will I be paying out of pocket for this claim?
  • Is pre-authorization required?
  • Do you accept a paper claim?
  • What documentation will I need to send with my claim?
  • Will I need to add any modifiers to my claim?
  • What percent of the cost of the CPAP equipment is reimbursable? Most only cover a portion of the cost so be sure to ask and never assume.
  • What deductible or co-pay amount must be met before I am eligible for any reimbursement?
  • Will I get a new machine? Not necessarily – again, be sure to ask.

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Sleep Apnea And Auto Insurance

Sleep apnea affects life and health insurance, but car insurance isn’t directly impacted. However, if your sleep apnea causes you to drive poorly and get into accidents, this would lead to high rates.

“Since fatigue is a factor in accidents, sleep apnea can put you indirectly at a higher risk of getting into a car accident,” says Scott Hoffman, an agent and principal of the Howard & Hoffman Insurance Agency. A study by the Vancouver Coastal Health Research Institute and the University of British Columbia found that people with sleep apnea are at double the risk of being in a car crash.

So, sleep apnea can affect your insurance, but make sure you follow guidance, such as following prescriptions, to make sure you protect yourself against running into a problem with your insurer.

It Is In Keeping With The Industrys Playbook Of Shifting The Costs Of Widely Used Therapies Devices And Tests To Unsuspecting Patients

Last March, Tony Schmidt discovered something unsettling about the machine that helps him breathe at night. Without his knowledge, it was spying on him.

From his bedside, the device was tracking when he was using it and sending the information not just to his doctor, but to the maker of the machine, to the medical supply company that provided it and to his health insurer.

Schmidt, an information technology specialist from Carrollton, Texas, was shocked: I had no idea they were sending my information across the wire.

Schmidt, 59, has sleep apnea, a disorder that causes worrisome breaks in his breathing at night. Like millions of people, he relies on a continuous positive airway pressure, or CPAP, machine that streams warm air into his nose while he sleeps, keeping his airway open. Without it, Schmidt would wake up hundreds of times a night then, during the day, he would nod off at work, sometimes while driving and even as he sat on the toilet.

I couldnt keep a job, he said. I couldnt stay awake. The CPAP, he said, saved his career, maybe even his life.

As many CPAP users discover, the life-altering device comes with caveats: health insurance companies are often tracking whether patients use them. If they are not, the insurers might not cover the machines or the supplies that go with them.

Insurers say their concerns are legitimate. The masks and hoses can be cumbersome and noisy, and studies show that about third of patients dont use their CPAPs as directed.

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Does Medical Insurance Help Pay For Sleep Apnea Therapy

Sleep apnea is a disorder where your breathing repeatedly stops and starts as you sleep. If you snore and you usually feel fatigued even after a full night of sleep, you may have sleep apnea.

Obstructive sleep apnea is the most common type of sleep apnea. This occurs because your throat is narrowed as you sleep, stopping airflow. Snoring is a loud sound caused by air squeezing through that narrow space. Sleep apnea studies have shown that OSA is more likely to occur in older and overweight males.

Sleep Apnoea Related Faqs

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  • Can I get travel insurance if I have sleep apnoea?
  • In most cases we can offer cover for sleep apnoea. Sleep apnoea may be automatically covered free of charge if you meet the criteria for automatic coverage, or you may have to pay an addition premium based on a quick medical assessment when purchasing your policy.

  • Do I need to tell you about my sleep apnoea?
  • Firstly, you should check that you meet the criteria for automatic cover . If you do not meet the auto-cover criteria or you are not sure, you can disclose you sleep apnoea by completing a medical assessment online or over the phone.

  • What if my partner has sleep apnoea?
  • Firstly, if your partner has sleep apnoea and they are taking out a travel insurance policy, then you should check that they meet the criteria for automatic cover. If they do not meet the auto-cover criteria or you are not sure you can disclose their sleep apnoea by completing a medical assessment either online or over the phone .

  • What if i develop sleep apnoea after ive bought travel insurance?
  • If your sleep apnoea was newly diagnosed and you didnt have any signs, symptoms or investigations prior to purchasing you policy, and your doctor says your fit to travel, then you may still have a provision to claim for unforeseen incidents that arise from your sleep apnoea.For any future policies you would need to check if you meet criteria for automatic coverage, or carry out a medical assessment before purchasing your policy.

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What Are Some Examples Of Pre

Chronic illnesses and medical conditions, including many forms of cancer, diabetes, lupus, epilepsy, and depression may be considered pre-existing conditions. Pregnancy before enrollment is also considered pre-existing and chronic, though less severe conditions such as acne, asthma, anxiety, and sleep apnea may also qualify.

Sleep Apnea Insurance Coverage For Cpap Therapy

Since CPAP is the most common form of sleep apnea therapy, its generally covered by most insurance policies. CPAP is considered to be durable medical equipment, writes Dr. Helene A. Emsellem, director of the Center for Sleep and Wake Disorders.

Supplies are covered separately, and the amount of coverage varies by state, Dr. Emsellem adds. Deductibles and copayments may apply depending on whether or not you have a secondary insurance.

Oral appliances for sleep apnea are also generally covered by insurance, but this area can get a little complicated. Typically, oral treatments will be covered by your medical insurance, and not by your dental insurance. Since a dentist specializing in sleep medicine will fit your sleep apnea oral appliance, this means youll have to work with both your dentist and your medical insurance coverage provider to figure out what level of coverage youre eligible for.

So, does insurance cover sleep apnea therapy? Chances are good that, if youve been diagnosed with a form of sleep apnea, your condition is considered medically necessary enough to be covered. And chances are also good that your doctor will only recommend therapy that your insurance provider will cover. But since every situation is different, the only way to find out for sure is to call your insurance provider and ask.

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Health Insurance For Tonsillitis Treatment

Tonsillitis is a painful condition and can cause difficulty in breathing and swallowing food which can cause serious difficulty in overall life. Most policies do not cover medical management for tonsillitis but they do cover tonsillectomy surgery.

As health insurance in India is not as prevalent as it is in developed countries, most people are not aware of the pitfalls regarding tonsillectomy coverage by health insurance in India.

  • Since tonsillectomy is a daycare procedure, it is not considered a major surgery by most insurance providers. Most insurance providers have a waiting period of 1-2 years for tonsillectomy, so they will not cover the surgery if you are getting the surgery as soon as you get the policy.
  • There is generally a sub-limit on the insurance sum that can be spent on tonsillectomy. Some insurance policies even cap the coverage at a specific amount, i.e., the expenses for the treatment must be within a certain limit, or the patient will have to pay the balance from their own hand.
  • Some policies have different coverage terms for children and adults. So make sure to check the specific policy terms.

Apnea Hypopnea Index And Oxygen Levels

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Sleep apnea is usually diagnosed using some form of sleep study or monitoring. The life insurance company will want the results of your most recent study, which will include the following data:

  • Apnea hypopnea index /respiratory disturbance index : Number of pauses in breathing or instances of shallow breathing per hour of sleep

  • Oxygen saturation: A measure of your blood oxygen levels, which decreases if breathing is paused or shallow

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