Medicare pay for second sleep study?

I had a sleep study four years ago and have mild sleep apnea. I would like another sleep study to see if I still have sleep apnea. Under what circumstances will Medicare cover it?

Have you been using a CPAP since you were diagnosed 4 years ago?

WANTOKPORO wrote:I had a sleep study four years ago and have mild sleep apnea. I would like another sleep study to see if I still have sleep apnea. Under what circumstances will Medicare cover it?

No matter what you will need a Dr.'s Order for Medicare to cover anything, so start there. You didn't mention why you...

I would like another sleep study to see if I still have sleep apnea.

So it's hard to advise past the Dr.'s Order.

I don't really know much about Medicare, as I'm still several years too young. However, I don't think that having had a test fours years earlier would be an obstacle.

Unless there have been dramatic changes in your health, you probably still have it.
Since you are wondering about it, I suspect you are having suspicious symptoms.
Talk to your doctor, ASAP. Cancer is not the only thing that gets worse if you do nothing.

If they had a data XPAP, and used it correctly, used the software it monitor their treatment,they would have a Sleep Study every night. I'm guessing no on all counts. Jim

Medicare paid for me to have two sleep studies and two titration studies in less than one year. The first studies were considered invalid because the doctor that requested them did not document a face to face meeting where sleep apnea was discussed prior to scheduling the studies. I made an appointment with a different doctor and had the studies repeated. The second doctor specializes in sleep disorders. As long as a doctor recommends the study, Medicare will pay for it.

My Medicare Advantage plan (Essence) did ok a second sleep study, but come to find out they will not pay for a new machine more frequently than 5 year intervals. So I have wasted $90 in specialist visits and tests so far and just found out I can't get a new machine. I should have checked with either of both of my Advantage provider and my respiratory pharmacy to make sure of this before I ever saw the so-called "sleep specialist". I now have to look forward to paying another $45 to see the sleep doctor (a neurologist) about the results of the sleep study.

I was so spoiled before I went on Medicare. I had a Family Care doctor who had a staff that always knew about these kinds of hiccups in the system. He himself taught digital medical recordkeeping and was always on top of whatever I might need. I lost him because my Medicare Advantage plan excluded his clinic.

It is a PITA, but always, always check with your insurance provider before seeing a specialist. This is going to cost me at least $135 and I doubt that I get any benefit from all the appointments, the echocardiogram (which may still cost me even more) and the sleep study, which is certainly no fun to take.

Original Medicare vs Medicare "Advantage": a very big difference.
Do not sign up until you do your research.
Do not sign up late--it will cost you.

Okie bipap wrote:Medicare paid for me to have two sleep studies and two titration studies in less than one year. The first studies were considered invalid because the doctor that requested them did not document a face to face meeting where sleep apnea was discussed prior to scheduling the studies. I made an appointment with a different doctor and had the studies repeated. The second doctor specializes in sleep disorders. As long as a doctor recommends the study, Medicare will pay for it.

I think you just lucked out on this one. Given all the crap I've had just on repeat blood tests (both endocrinologist and GP running same blood test), I can't imagine Medicare giving the OK for a study that costs hundreds of dollars. BUT, you never know. In general, Medicare will only pay for another study if at least 5 years have passed UNLESS there is a medical reason to do another one. Just seeing another practitioner won't do it.