Is the Appliance Covered by Insurance?
Very few, if any, dental insurance companies will cover oral appliance therapy. If you are going to file for insurance to cover the costs of the appliance, file for medical insurance not dental insurance. Usually oral appliances fall under the same category as durable medical equipment and prostheses. If this is not the case, ask if oral appliances are covered by the insurance benefits. The insurance companies will likely require: • Copy of Polysomnogram (PSG or sleep study) • Diagnosis code(s) used by physician • Copy of prescription for oral appliance from physician • Letter of medical necessity from physician • Treatment code(s) used by orthodontistBe sure to tell the claims personnel that you have a CPT code. This will speed up the approval process.
