Understand the Cost of Appliance Therapy

Oral application therapy is the alternative treatment method to CPAP for treating obstructive sleep apnea (OSA). It includes two devices, one that looks like a mouthguard and another dental device that stabilizes the tongue. Quincy Dental Associates offers oral appliance therapy in Quincy, MA. However, the biggest concern for patients is usually the appliance therapy costs.

Obstructive sleep apnea (OSA) is the leading type of sleep apnea. It occurs when the upper airway is temporarily blocked partly or fully during sleep. Breathing is usually resumed with a gasp, thanks to the overworking diaphragm and chest muscles. It’s characterized by snoring, sore throat, sexual dysfunction, irritability, daytime sleepiness, and night sweats.

Treating obstructive sleep apnea can be done using two main techniques. They are oral appliance therapy and continuous positive airway pressure therapy. This article explores the costs of appliance therapy, including a cost-benefit analysis of appliance therapy, insurance, and out-of-pocket expenses. It will also highlight how the price compares with the conventional treatment method.

Breakdown of Cost of Appliance Therapy

The cost of oral appliance therapy usually depends on some factors. They include the location of the procedure, the type of appliance, and the experience of the sleep specialist that provides your treatment. The insurance coverage for appliance therapy also determines the cost of the overall procedure. Overall, it ranges from a few hundred to several thousand dollars.

Like any other treatment, when paying for appliance therapy, there are out-of-pocket expenses for appliance therapy. Most of these costs come about because of untransparent pricing, region, the specific device used, and the patient’s details on the insurance plan.

Is Oral Application Therapy Worth It?

Oral application therapy is usually a treatment option for individuals with mild to moderate obstructive sleep apnea. It is also an alternative for individuals who cannot withstand continuous positive airway pressure (CPAP) therapy. It’s an ideal alternative since it’s comfortable and effective in minimizing snoring and enhancing sleep quality.

If you fall within the above bracket, application therapy is worth it, cost-wise. Beyond daily costs, CPAP looks cheap in the first few months, but as time passes, the costs keep rising. On the other hand, you can take advantage of the long-term cost savings of appliance therapy. The costs are almost like CPAP in the first four months of the treatment.

After four months, there are no other costs for OAT, while CPAP keeps rising due to the regular replacement of components. By the end of 5 years, you only used about 40% of what you would have used were it for CPAP.

Here’s an Insurance Tip

A patient may default on the utilization of either CPAP or OAT. In such a case, the insurer is prompted to terminate the coverage. If the insurance coverage for the therapy is removed, the affected patient will have increased out-of-pocket expenses. For CPAP therapy, the insurer requires patients to physically visit the physician and verify the use of the gadgets. Usually, they must be put on for not less than 4 hours and on 70% of the nights. Furthermore, CPAP machines collect and submit data to the clinicians, thus reporting on the utilization in frequency and duration of use.

With oral application therapy, clinicians rely solely on the patients or their partners to report utilization data. It is, therefore, difficult for insurers such as Medicare to terminate coverage for OAT plans. Also, studies have shown that patients are more likely to adhere to OAT than CPAP. Better adherence translates to effective treatment and less cost for treatment.

Why Oral Appliance Therapy is Worth Your Money

Initial insights suggest that CPAP is cheaper when compared to OAT. However, after a deeper analysis of the costs of both therapies over several years, it’s evident that appliance therapy is the more cost-effective option for individuals with mild to moderate obstructive sleep apnea and those who are uncomfortable using a CPAP machine.

Considering the effectiveness of the OAT and cost benefits, it’s worth your money for factors such as clinical requirements for reimbursements and insurance reimbursement schedules. Its costs are more fixed with a single upfront payment, while those of a CPAP machine include a low initial price and recurring expenses.