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

Cover image
Does Medicare Cover Shock Wave Therapy for Plantar Fasciitis?
Nov 30, 2022
Cover image
The Fair Square Bulletin: October 2023
Oct 2, 2023
Close up top view of a woman showing a round-shaped Lipoma fatty tumor on an open palm stock photo
Does Medicare Cover Lipoma Removal?
Dec 8, 2022
senior man receiving dental care stock photo
Will Medicare Cover Dental Implants?
Jun 2, 2022
Doctor physician consulting with male patient in hospital exam room stock photo
Does Medicare Cover Penile Implant Surgery?
Dec 9, 2022
Senior person holding tissue roll near a toilet bowl, using walker to walk to the bathroom stock photo
Does Medicare Cover Oxybutynin?
Dec 2, 2022
scleral lenses
Does Medicare Cover Scleral Lenses?
Dec 5, 2022
Medicare at 62 stock image
Does Retiring at Age 62 Make Me Eligible for Medicare?
Jun 16, 2022
Teenager Helping his Grandfather at Home stock photo
Does Medicare Cover Geri Chairs?
Dec 7, 2022
Caucasian nurse holding spine model against the patients backs. Clinic interior. stock photo
Does Medicare Cover SI Joint Fusion?
Nov 28, 2022
hand holding up Invisalign stock photo
Does Medicare Cover Orthodontic Care?
Nov 18, 2022
Asian senior male patient having him eyes examined by laser machine
Finding the Best Vision Plans for Seniors
Jan 6, 2023
Myelofibrosis stock image
Does Medicare Cover Jakafi?
Dec 12, 2022
Doctor physician consulting with male patient in hospital exam room stock photo
Is Gainswave Covered by Medicare?
Dec 6, 2022
Cover image
Medicare Advantage MSA Plans
May 17, 2023
Washington DC stock image
14 Best Ways for Seniors to Stay Active in Washington, D.C.
Mar 11, 2023
woman working from home with a headset on stock image
How Do Medicare Agents Get Paid?
Apr 12, 2023
What is the ICEP?
What is the Medicare ICEP?
Apr 7, 2023

More of our articles

13 Best Ways for Seniors to Stay Active in Columbus

13 Best Ways for Seniors to Stay Active in Jacksonville

14 Best Ways to Stay Active in Charlotte

20 Questions to Ask Your Medicare Agent

2024 Fair Square NPS Report

Can Doctors Choose Not to Accept Medicare?

Can I Change Medicare Advantage Plans Any Time? | Medicare Plans

Costco Pharmacy Partners with Fair Square

Do I Need Medicare If My Spouse Has Insurance?

Do I Need to Renew My Medicare?

Do Medicare Supplement Plans Cover Dental and Vision?

Do You Need Books on Medicare?

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

Does Medicare Cover Bariatric Surgery?

Does Medicare Cover Bladder Sling Surgery?

Does Medicare Cover Boniva?

Does Medicare Cover Breast Implant Removal?

Does Medicare Cover Cardiac Ablation?

Does Medicare Cover Cartiva Implants?

Does Medicare Cover Chiropractic Visits?

Does Medicare Cover Compounded Medications?

Does Medicare Cover Driving Evaluations?

Does Medicare Cover Fosamax?

Does Medicare Cover Hepatitis C Treatment?

Does Medicare Cover Inspire for Sleep Apnea?

Does Medicare Cover Linx Surgery?

Does Medicare Cover LVAD Surgery?

Does Medicare Cover Ozempic?

Does Medicare Cover Physicals & Blood Work?

Does Medicare Cover Robotic Surgery?

Does Medicare Cover RSV Vaccines?

Does Medicare Cover Service Animals?

Does Medicare Cover Vitamins?

Does Medicare Cover Wart Removal?

Does Medicare Cover Xiafaxan?

Does Medicare Have Limitations on Hospital Stays?

Does Medicare Pay for Antivenom?

Does Medicare pay for Opdivo?

Does Medicare Pay for Varicose Vein Treatment?

Does Your Plan Include A Free Gym Membership?

Estimating Prescription Drug Costs

Everything About Your Medicare Card + Medicare Number

Fair Square Bulletin: We're Revolutionizing Medicare

How Does Medicare Cover Colonoscopies?

How Does Medicare Pay for Emergency Room Visits?

How Much Does Medicare Cost?

How Much Does Medicare Part A Cost in 2025?

How Much Does Rexulti Cost with Medicare?

How Much Does Xeljanz Cost with Medicare?

How Often Can I Change Medicare Plans?

How to Deduct Medicare Expenses from Your Taxes

Is Emsella Covered by Medicare?

Is PAE Covered by Medicare?

Is the Shingles Vaccine Covered by Medicare?

Is Vitrectomy Surgery Covered by Medicare?

Medicare Explained

Medicare Savings Programs in Kansas

Medicare Supplement Plans for Low-Income Seniors

Medigap vs. Medicare Advantage

Seeing the Value in Fair Square

Should You Work With A Remote Medicare Agent?

Top 10 Physical Therapy Clinics in San Diego

What Are Medicare Part B Excess Charges?

What Happens to Unused Medicare Set-Aside Funds?

What If I Don't Like My Plan?

What Is a Medicare Advantage POS Plan?

What is a Medicare Beneficiary Ombudsman?

What People Don't Realize About Medicare

What To Do If Your Medicare Advantage Plan Is Discontinued

What to Do When Your Doctor Doesn't Take Medicare

What's the Deal with Flex Cards?

Why You Should Keep Your Medigap Plan

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