Cost & Insurance

What Are Oral Appliances for Sleep Apnea?

Oral appliances are custom-fitted devices that treat obstructive sleep apnea by gently repositioning your lower jaw forward during sleep. This keeps your airway open so you can breathe normally throughout the night.

Mandibular advancement devices (MADs) are the most common and widely studied type of oral appliance. These are custom-made using digital impressions of your teeth to ensure a precise fit for your jaw alignment.

Oral Appliances vs. CPAP Machines

CPAP is often the first treatment physicians prescribe for obstructive sleep apnea. It works by delivering pressurized air through a mask to keep the airway open during sleep. While CPAP is highly effective, many patients struggle with mask discomfort, bulky equipment, air leaks, or feelings of claustrophobia — which can limit long-term use.

Oral appliance therapy is the second most common evidence-based treatment for obstructive sleep apnea. These custom-fitted devices — similar to a mouthguard — gently reposition the lower jaw forward to help keep the airway open during sleep. Because there’s no mask, hose, or machine involved, oral appliances are simple to use, easy to travel with, and allow patients to sleep comfortably in any position. Oral appliances are especially effective for mild to moderate sleep apnea and for patients who are unable to tolerate CPAP.

Health Insurance Coverage and Payment Options

Most major health insurance plans cover oral appliance therapy for sleep apnea, including Medicare, Medicare Advantage, Anthem, and UHC plans. Look for providers who handle the insurance pre-authorization process for you before you start treatment.

Your out-of-pocket costs typically include any remaining deductible for the year, plus your plan’s copay or coinsurance. Since coverage varies by plan, verify your specific benefits upfront to avoid surprises.

Medicare Coverage

Medicare Part B covers custom oral appliances when medically necessary. You’ll need a sleep apnea diagnosis and prescription from your physician. Providers can work directly with Medicare to manage approvals and billing.

HSA and FSA

Oral appliance therapy qualifies for Health Savings Account (HSA) and Flexible Spending Account (FSA) payments, allowing you to use pre-tax dollars toward treatment costs.

What Affects Your Out-of-Pocket Cost?

Your final cost depends on your insurance plan’s deductible, copay, and coinsurance requirements. Find providers using the same high-quality, custom-fitted oral appliances for all patients. Your health insurance benefits determine what you’ll pay, not device “tiers” or upgrades.

Cost of Oral Appliance for Sleep Apnea vs. Other Treatments

When billed through insurance, oral appliance therapy typically costs about half as much as CPAP therapy over five years. Here’s how the costs compare:

CPAP Therapy:

Requires ongoing replacement supplies like masks, filters, and tubing, plus electricity costs to run the machine each night.

Oral Appliances:

No replacement supplies are needed – only the initial custom device and occasional adjustments during follow-up visits are required.

General Dentists:

General dentists who occasionally provide oral appliances often bill the service as a dental procedure, which typically isn’t covered by medical insurance. Providers who specialize in dental sleep medicine, like Alterna Sleep, bill through your medical insurance — significantly reducing what you pay.