Home Sleep Study: Insurance versus Self Pay

Home Sleep Study Cost and Options

It’s that time of year again when people with health insurance will notice their deductible is about to roll over. Insurance is one of those words that feel like a safety blanket to protect you against high out of pocket cost for unexpected tests or treatment but in a lot of cases you are not protected until you meet that dreaded deductible. With each passing year the average deductible increases while often times the amount of covered percentage decreases.  More people are finding that self pay (paying out of your own pocket) is a cheaper alternative than using insurance. Yes, you read that correctly, if you are looking for home sleep study cost, replacement CPAP machines, masks or supplies shopping online could save you hundreds of dollars when you pay for them yourself.

CPAP Stores

Leave a Little Extra in Your Wallet This Year. Shop 1800CPAP.com

Don’t just take our word for it, call your DME (durable medical equipment) provider after your deductible rolls over and tell them you are looking to get a new CPAP mask. They will run a benefits check on your policy and if you have ANY deductible or co-pay they will let you know what your coverage is. They will then provide you with the mask and bill your insurance and apply that towards your deductible but since you aren’t covered at 100% you will receive a bill from them for the entire cost which for most products can be as high as 3X the amount of what you could get it for self pay. A full face mask might cost you over $350 dollars when you use your healthcare plan versus $125 if you bought that same mask from 1800CPAP.com.

How My Insurance Works

You select a coverage plan and pay a monthly premium towards it. To keep your monthly out of pocket cost down you can select a cheaper policy however it comes with a higher deductible and less coverage. You have a deductible which is the amount of money you pay out of your own pocket before your insurance kicks in. This resets each year, usually on January 1st or July 1st. After you have reached your deductible for the year THEN your insurance starts paying towards your insurance claims. The amount you owe will be based on your individual plan coverage. So if you are covered at 80%, then you still owe 20% of everything AFTER you have met your entire deductible.

Sleep Apnea Causes and Symptoms

Traditional Sleep Testing Costs

Most people seeking sleep apnea testing are typically referred to a sleep specialist for consultation. If you have sign or symptoms of sleep apnea your doctor will order an overnight diagnostic test in a sleep laboratory to rule out sleep disordered breathing. You will typically see the doctor again in a follow up appointment to discuss the results of the study and if your results were positive for sleep apnea another overnight stay in the sleep lab will be ordered for treatment. During this phase you will be hooked up to all of the same wires as your first test with the addition of a CPAP mask. The sleep technicians will increase CPAP pressure to find optimal setting that eliminates apnea. A follow up visit is scheduled with your doctor to discuss progress and CPAP usage. See the breakdown below for potential cost when choosing this route. This process could cost you as much as $5000.00 out of pocket and does not include a PAP therapy device that could cost you as much an additional $3000.00

Home Sleep Study

Affordable Low Cost Sleep Study Option

Avoid the hassle, headache and high cost of traditional sleep testing and order and easy to use at home sleep study kit for just $249. We ship a type III diagnostic test kit to your house with simple to follow instructions to be used that night. We use board certified sleep physicians that interpret the results of the study and provide recommendation and FREE prescription for therapy. The typical treatment for sleep disordered breathing is an auto adjusting CPAP machine, a device that detects airway closure and increases and decreases to optimal pressure setting throughout the night.

A big question that always comes up is how we can charge $249 for something that in-lab facilities charge thousands for. The answer is simple; we don’t have the expensive overhead of staffing multiple professional sleep techs throughout the night to watch you nor do we have the expensive rent of a building to conduct the test in. Most of these sleep labs use the same at home sleep study kit but only recommend it to a few patients because they need to fill the beds of the sleep lab. Arguments have went back and forth for years in the sleep medicine community about the importance for in-lab testing and the unreliability of a home sleep study but studies in these devices have been shown to be just as reliable to diagnose the typical obstructive sleep apnea sufferer. So how do I know which sleep test is right for me?

A Home Sleep Study is Right for You If….
Home Sleep Study

Home Sleep Study Test Kit

At home sleep studies are most commonly recommended for people suspected of having the most common of apnea classifications, obstructive sleep apnea. This type of apnea is a blockage or partial blockage that occurs in a person’s airway caused by excess tissue that collapse once muscles have relaxed during sleep (usually in people with necks size greater than 17 inches). An enlarged tongue or uvula can also be a culprit if it fall back causing restricted air to the lungs.

If you have been told that you stop breathing during your sleep or have loud snoring it is most likely caused by OSA (obstructive sleep apnea).

The home sleep study (HSS) that we administer is a Type III device that measures air flow, respiratory effort, oxygen saturation and heart rate and is recommended for those that:

  1. High pre-test probability of sleep apnea (you suspect you may have it)
  2. Have a neck size greater than 17 inches in men; 16 inches in women.
  3. Have a BMI (body mass index) greater than 30
An In-Lab Sleep Test is Right for You If….
In Lab Sleep Study

In-Lab Sleep Study

An at home sleep study is a great economical option for people that suspect they have sleep disordered breathing BUT in some cases it is recommended that a person undergo an in-lab study; those would include:

  1. You suffer from COPD (chronic obstructive pulmonary disease)
  2. You suffer from CHF (congestive heart failure)
  3. You suspect one of the following disorders:  central sleep apnea, narcolepsy, seizures, or parasomnia
  4. You use supplemental oxygen
  5. You have a chronic use of opiates

 

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