Insurers May Not Be Happy about Sleep Apnea Testing
Earlier this year we lost actor James Gandolfini, whose award-winning run on what has been called the greatest TV show in history, The Sopranos, showed his tremendous talent and promise for the future. Unfortunately, his career was cut short by a fatal heart attack. Although he reportedly had a phenomenally loud snore, he was never evaluated for sleep apnea, which may have contributed to his heart attack risk.
Gandolfini’s story is a common one. Perhaps as much as 90% of sleep apnea sufferers went undiagnosed. Undiagnosed, sleep apnea increases the risk of numerous injuries and fatal conditions, from workplace and car accidents to stroke and heart attack.
Now sleep apnea is finally getting the attention it deserves, with more people seeking out sleep clinics and sleep doctors for diagnosis and getting appropriate treatment. Unfortunately, this is causing resistance from the insurance industry.
Why the Insurance Industry Is Grumbling
Sleep apnea diagnosis and treatment is becoming much more common, which means that insurers are being asked to spend more money on it. The amount spent on sleep testing has increased from $62 million in 2001 to $235 million in 2009, with insurers footing most of the bill. Any time an expense category increases nearly 300%, it’s going to hit the bottom line hard and a business is going to be upset. In this case, the insurance industry has been grumbling that sleep apnea testing isn’t always necessary and treatments may not be, either. They even go so far as to suggest that some doctors are either ignorant or trying to make extra profit with testing.
Why the Insurance Industry Should Be Happy
The insurance industry should be happy about the booming sleep apnea business, however, because although it costs them money now, it will save them money in the long run.
Consider the cost of sleep apnea treatment, which includes the sleep apnea test (about $2000 in a sleep center, much less for an at-home test) and the CPAP machine (up to $2500) or oral appliance (which costs about the same as CPAP in most cases). In other words, treating sleep apnea costs about $4500.
But the cost of not treating sleep apnea? Consider a few of the risks associated with sleep apnea. Coronary artery disease is treated with balloon angioplasty, which costs about $30,000-$48,000. A heart attack has a lifetime treatment cost of $760,000-1 million.
And insurers with auto insurance divisions should be happy, too. People with sleep apnea are twice as likely to be involved in serious injury or fatal car accidents. The average cost of an injury car accident is about $66,000, with the insurance company paying half of that, and the average cost of a fatal car accident is more than $3 million, although insurers pay a much smaller portion.
Let Us Handle the Insurance Company
If you suspect you may be suffering from sleep apnea, it’s important that you get diagnosis and treatment. It can save your life and it can save you (and your insurance company) significant medical costs. We can work with your insurance company to make sure they cover costs according to your policy, whether they like it or not.