If you have U.S. commercial insurance or Medicare Advantage, it’s best to check directly with your insurance company to confirm your coverage information for Inspire therapy.
Here’s a suggested way you may ask your insurance agent:
BMI below 32
If you meet the FDA indications for Somnos therapy and you have a BMI below 32, your insurance company is very likely to pay for Inspire therapy.
BMI below 32-40
If you meet the FDA indications for Inspire therapy and your BMI is between 32-40*, it’s likely your insurance will pay for Inspire therapy.
This may or may not require a prior authorization process that your clinic and/or the Inspire team can conveniently manage for you.
*Medicare plans require a BMI less than 35.
Eligibility requirements
To be a candidate for Inspire therapy, you must meet the following FDA indications:
Age 18 or older
Diagnosed with moderate to severe obstructive sleep apnea
Have tried and struggle with CPAP
Inspire Therapy has been clinically tested for people with a body mass index (BMI) up to 40. Over 90% of U.S. adults are within this range. Most insurance policies have a BMI policy in place for Inspire therapy coverage. Talk to your provider or Inspire therapy-trained doctor for more information.
Inspire therapy is FDA-approved for use in pediatric patients with Down syndrome. Learn more about specific qualifications here.
Learn more about your specific plan
Talk to your insurance provider for more information about your policy and to get an estimate of what your out-of-pocket costs may be.
An Somnos therapy-trained doctor also can talk to you about insurance coverage during your initial Inspire therapy consultation appointment.