Fair Square Medicare Wordmark

Does Medicare Cover Inspire for Sleep Apnea?

Sleep apena stock image
By Daniel Petkevich
Dec 27, 2022

See if you might qualify

A critical part of a long and healthy life is restful sleep. This is easier said than done with sleep apnea. Luckily, if your doctor deems the Inspire implant to be medically necessary, you can get coverage through Medicare. But how does it work? Let's find out.

Stay Up to Date on Medicare!

Join the Fair Square Medicare Newsletter to stay informed on cost savings, changes to Medicare, and other valuable healthcare information.

What is Sleep Apnea and How Is It Treated?

Sleep apnea is a sleep disorder where your breathing repeatedly stops and starts while you are sleeping. It is caused by the muscles in the throat becoming too relaxed, which can cause your airway to collapse. Sleep apnea can be treated with a

mouth guard

or CPAP machine. Another option is the Inspire implant. Inspire therapy helps people with obstructive sleep apnea (OSA) breathe more easily during sleep by stimulating the hypoglossal nerve. This nerve helps to keep the airway open.

Does Medicare Cover the Cost of an Inspire Implant?

Yes, Medicare Part B covers the cost of an Inspire implant if your doctor deems it medically necessary. If you have Medicare Part B and meet all other coverage requirements, you may qualify for coverage of Inspire therapy. Coverage includes the device itself and any related procedures performed by your doctor.
While you'll have coverage, there might still be out-of-pocket expenses such as deductibles, copays, and coinsurance up to 80% of the total cost. With the Inspire implant priced around $30,000 to $40,000, this can be a huge bill. The best way to limit out-of-pocket exposure is with

Medicare Supplement Plan G

.

What Types of Tests Are Required to Determine Eligibility for Medicare Coverage?

To be eligible for coverage, your doctor must complete a series of tests and provide the results to Medicare. These tests include a sleep study, an airflow evaluation, and a physical examination. Your doctor will also review your medical history and assess whether Inspire therapy is medically necessary for improving your quality of life.

What Is the Process for Obtaining an Inspire Implant Through Medicare?

Once your doctor has determined that you are eligible for coverage under Medicare, they will submit all the necessary documentation to Medicare. The process typically takes a few weeks and may involve getting pre-approval from your local Medicare office. After approval is obtained, your doctor will schedule an appointment to have the device implanted.

Other Considerations When Deciding Whether or Not to Get an Inspire Implant?

Getting an Inspire implant is a big decision, and it’s important to weigh all the pros and cons before proceeding. Make sure you understand the risks of undergoing this procedure, as well as any potential side effects or complications that may arise from having the implant. Your doctor should be able to answer any questions you have about the procedure and help you make an informed decision.

Benefits of Getting an Inspire Implant Through Medicare

Getting an Inspire implant through Medicare will save you money on the cost of the device and any related procedures. It can also help improve your quality of life by reducing snoring, daytime sleepiness, and other symptoms associated with OSA. Additionally, since Medicare is covering your procedure, you’ll have access to high-quality healthcare

Tips on Making Sure You Receive Proper Treatment With Your Insurance Provider

When working with your insurance provider for coverage of an Inspire implant, it’s important to make sure you are getting the care and treatment that you need. Have all of your questions ready before any appointments, and make sure you understand what is covered by your policy. Be prepared to present evidence from your doctor that shows the procedure is medically necessary. Additionally, be aware of any coverage limitations and exclusions in your policy before treatment. With the proper preparation, you can ensure you receive the best care possible from your insurance provider.

Takeaway

There is no substitute for a good night's sleep. If Inspire is the right sleep apnea treatment for you, Medicare might cover it if your doctor considers it medically necessary. Be sure to talk with your doctor before pursuing any treatment. This content is for informational purposes only. If you have any Medicare questions, Fair Square Medicare has a team of experts ready to help you. Call us now.

Stay Up to Date on Medicare!

Join the Fair Square Medicare Newsletter to stay informed on cost savings, changes to Medicare, and other valuable healthcare information.

Recommended Articles

Daniel Petkevich demonstrates Medicare coverage by using a scarf and hat as a metaphor
Medicare 101
May 20, 2020
Hepatitis C stock photo
Does Medicare Cover Hepatitis C Treatment?
Nov 22, 2022
Pre-Existing condition stock image
Can Medicare Advantage Plans Deny Coverage for Pre-Existing Conditions?
Mar 28, 2023
senior man with his glasses in his hand working in front of his laptop stock photo
Can I Change Medicare Advantage Plans Any Time? | Medicare Plans
Sep 19, 2022
Male doctor with his arms crossed stock image
Can Doctors Choose Not to Accept Medicare?
Dec 8, 2022
Closeup of a male Doctor or physiotherapist doing stretching for a patient in the clinic for examining treating injured of back stock photo
Does Medicare Cover Chiropractic Visits?
Dec 22, 2022
scientist mixing chemical compounds stock image
Does Medicare Cover Compounded Medications?
Apr 4, 2023
cartoon hospital and male doctor stock image
Can I Have Two Primary Care Physicians?
Oct 3, 2022
Electrocardiograph with pacemaker stock photo
How Much Does a Pacemaker Cost with Medicare?
Nov 21, 2022
Hands of doctor or nurse in medical gloves injecting a shot to a man patient stock photo
Does Medicare Pay for Allergy Shots?
Nov 29, 2022
Older woman during an eye exam
Does Medicare Cover Diabetic Eye Exams?
Jan 11, 2023
Senior woman having vision problems stock photo
Does Medicare Cover Macular Degeneration?
Nov 30, 2022
Plastic surgeon handles a silicon implant
Does Medicare Cover Breast Implant Removal?
Jan 5, 2023
Cover image
Fair Square Bulletin: We're Revolutionizing Medicare
Apr 27, 2023
Senior person holding tissue roll near a toilet bowl, using walker to walk to the bathroom stock photo
Is Emsella Covered by Medicare?
Nov 21, 2022
scleral lenses
Does Medicare Cover Scleral Lenses?
Dec 5, 2022
various people wearing masks due to the COVID-19 pandemic stock photo
How Does the End of the COVID-19 Public Health Emergency Affect Your Medicare?
Mar 3, 2023
Diagnosis overactive bladder stock image
Does Medicare Cover PTNS?
Dec 9, 2022

More of our articles

13 Best Ways for Seniors to Stay Active in Indianapolis

13 Best Ways for Seniors to Stay Active in Phoenix

14 Best Ways for Seniors to Stay Active in Washington, D.C.

2024 Fair Square NPS Report

Are Medicare Advantage Plans Bad?

Can I Laminate My Medicare Card?

Costco Pharmacy Partners with Fair Square

Do All Hospitals Accept Medicare Advantage Plans?

Do I Need Medicare If My Spouse Has Insurance?

Do You Need Books on Medicare?

Do You Need Medigap if You're Eligible for Both Medicare and Medicaid?

Does Medicare Cover Boniva?

Does Medicare Cover Cartiva Implants?

Does Medicare Cover Cold Laser Therapy (CLT)?

Does Medicare cover Deviated Septum Surgery?

Does Medicare Cover Driving Evaluations?

Does Medicare Cover ESRD Treatments?

Does Medicare Cover Home Heart Monitors?

Does Medicare Cover Incontinence Supplies?

Does Medicare Cover Inqovi?

Does Medicare Cover Inspire for Sleep Apnea?

Does Medicare Cover Jakafi?

Does Medicare Cover Kidney Stone Removal?

Does Medicare Cover Linx Surgery?

Does Medicare Cover Lipoma Removal?

Does Medicare Cover Mouth Guards for Sleep Apnea?

Does Medicare Cover Nexavar?

Does Medicare Cover Orthodontic Care?

Does Medicare Cover Qutenza?

Does Medicare Cover Robotic Surgery?

Does Medicare Cover Service Animals?

Does Medicare Cover Tymlos?

Does Medicare Cover Vitamins?

Does Medicare Cover Xiafaxan?

Does Medicare Cover Zilretta?

Does Medicare Pay for Bunion Surgery?

Does Medicare pay for Opdivo?

Does Your Plan Include A Free Gym Membership?

Estimating Prescription Drug Costs

Health Savings Accounts (HSAs) and Medicare

How Are Medicare Star Ratings Determined?

How Can I Get a Replacement Medicare Card?

How Do Medicare Agents Get Paid?

How Do Medigap Premiums Vary?

How Does Medicare Cover Colonoscopies?

How Does Medicare Pay for Emergency Room Visits?

How is Medicare Changing in 2025?

How Much Does Medicare Cost?

How Much Does Rexulti Cost with Medicare?

How to Deduct Medicare Expenses from Your Taxes

Is Balloon Sinuplasty Covered by Medicare?

Is Displacement Affecting Your Medicare Coverage?

Is HIFU Covered by Medicare?

Is PAE Covered by Medicare?

Medicare Advantage Plans for Disabled People Under 65

Medicare Consulting Services

Medicare Explained

Medicare Guaranteed Issue Rights by State

Medicare Supplement Plans for Low-Income Seniors

Plan G vs. Plan N

Seeing the Value in Fair Square

Should You Work With A Remote Medicare Agent?

The Easiest Call You'll Ever Make

Top 10 Physical Therapy Clinics in San Diego

What Happens to Unused Medicare Set-Aside Funds?

What Is the Medicare Birthday Rule in Nevada?

What People Don't Realize About Medicare

What You Need to Know About Creditable Coverage

What's the Deal with Flex Cards?

Which Medigap Policies Provide Coverage for Long-Term Care?

Why Is Medicare So Confusing?

Will Medicare Cover Dental Implants?

Your Medicare One-Stop-Shop

Your guide to Medicare Parts A & B, Medicare Advantage, and Medigap. 100% free.
Get the Fair Square Bulletin

Medicare savings tips, helpful guides, and more.

About

Medicare 101

Current Clients

Medicare Supplement Plans

Medicare Advantage Plans

Fair Square 2025

Terms of Use
Notice of Privacy Practices

Virgil Insurance Agency, LLC (DBA Fair Square Medicare) and www.fairsquaremedicare.com are privately owned and operated by Help Button Inc. Medicare supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. This is a solicitation of insurance. A licensed agent/producer may contact you. Medicare Supplement insurance is available to those age 65 and older enrolled in Medicare Parts A and B and, in some states, to those under age 65 eligible for Medicare due to disability or End-Stage Renal disease. Virgil Insurance Agency is a licensed and certified representative of Medicare Advantage HMO, HMO SNP, PPO, PPO SNP and PFFS organizations and stand-alone PDP prescription drug plans. Each of the organizations we represent has a Medicare contract. Enrollment in any plan depends on contract renewal. The plans we represent do not discriminate on the basis of race, color, national origin, age, disability, or sex. Plan availability varies by region and state. For a complete list of available plans please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov. © 2025 Help Button Inc

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.

MULTIPLAN_FairSquareMedicare_01062022_M