Abcds of medicare yihaes makonnen
In conclusion, Medicare does cover the cost of Inspire for the treatment of obstructive sleep apnea, but specific criteria must be met, and a pre-authorization process is required.īeneficiaries need to speak with their physician and insurance provider to ensure that they meet the specific criteria for coverage and to understand any additional costs not covered by Medicare. It is advisable to consult your insurance provider for a better understanding of your coverage. Your out-of-pocket expenses and limits can be significantly reduced if you have additional coverage, such as a Medigap or Medicare Advantage plan.
You will be responsible for the remaining 20% coinsurance, with no out-of-pocket limit. Medicare covers 80% of the cost of the Inspire device and the implantation surgery after the Part B annual deductible is met. In some cases (depending on the individual’s specific situation), the patient must also obtain an order from a physician stating that the Inspire therapy device is medically necessary to treat their sleep apnea.Īfter approval, the surgery to implant the device and the cost of the device itself are covered under Medicare Part B.
Medicare has a pre-authorization process that confirms the procedure is medically necessary for the patient and meets Medicare’s criteria.