HST Insurance Coverage

HST Insurance Coverage

With our last post, our discussion focused on insurance coverage and how it relates to CPAP equipment. We compared the differences between current private and public insurance trends vs. paying for equipment out of your pocket. This post will focus on HST Insurance and costs.

Home Sleep Tests (HST) and Insurance Coverage

In this post, we want to explore the idea that Home Sleep Testing (HST) equipment is less expensive, has a more extensive selection, and is easier to purchase online in a similar manner to CPAP equipment. Doctors are beginning to suggest more home sleep tests. That's because they are affordable, easy to administer, and provide accurate results. They also don’t require the scheduling and inconvenience of a traditional sleep lab. Lab sleep tests can cost between $1000 and $3000 per night while a home sleep test ranges from $250 to $500. Most insurance companies such as Medicare, Blue Cross, Blue Shield, Aetna, and Cigna cover the cost of an HST as long as the patient meets ‘medical necessity for a test.

Scheduling a sleep test in a lab can often take months as both the lab and the patient’s personal availability need to be considered. Children have to be cared for and a day off of work might be necessary. This has given rise to home sleep testing. A home sleep test can be taken the night it arrives in the mail. And, the results can be read by physicians in a few days. This efficiency produces quick results and recommendations. Once results are determined, a doctor can write a prescription for CPAP equipment. If ordered online, the prescription can have the person using it for a better night’s rest the very next day. Of course, having a board certified sleep doctor and legitimate, knowledgeable equipment provider is definitely necessary. Nevertheless, this speedy turnaround has many doctors prescribing HST.

HST Insurance vs. Sleep Labs Insurance

Could this trend lead to a massive reduction in traditional sleep lab tests, with all staff and equipment being phased out by the far less expensive home sleep testing products and procedures? As sleep issues come to the forefront and more people are in tune with the benefits of sleep, inexpensive and less cumbersome testing should become the norm. In fact, general practitioners are becoming more cognizant of potential sleep issues and can write a prescription for a sleep test.

What Sleep Doctors Think About the Future of HST

To get a more in-depth, expert opinion, we posed the questions below to two noted board certified sleep doctors:

What are your thoughts about home sleep testing?

Since it is less expensive than lab studies but just as effective, do you see HST becoming more accepted by the medical community?

Could the trend of HST becoming more prevalent lead to a massive reduction in traditional sleep lab testing?

Dr. Brandon Peters responded:

“There has been a major shift in the last few years towards home sleep apnea testing, but the need for in-center testing will persist. Mild obstructive sleep apnea can be missed with a home test. If the test is negative, a formal diagnostic polysomnogram may be required. In addition, there are disorders beyond sleep apnea that cannot be diagnosed at home. Children are also required to have in-center testing. Insurance often requires a board-certified sleep specialist to interpret the sleep test results. When treatment is required, a general practitioner may not have the experience or resources to deliver optimal care.”

Not only is Dr. Peters a board-certified sleep doctor, but he is also acutely in tune with the current sleep services industry. Read Dr. Peters bio here.

HST Insurance and Online Equipment

As technology improves - including better remote monitoring and reporting devices coupled with rising insurance premiums and declining deductibles - it seems like a natural progression for physicians to begin prescribing HST, and the devices can easily be bought online. This phenomenon, we believe, will follow a similar path as Durable Medical Equipment which has become a more online accessible marketplace. Ten years ago, buying CPAP equipment online was a very new experience. However, through improved patient knowledge and effective outreach, CPAP equipment is readily available. As long as patients are buying from reputable, patient-focused companies such as The CPAP Shop, the experience will be an easy and seamless one.

Chris Vasta

Chris Vasta is the president of The CPAP Shop and an expert in sleep and respiratory therapy. He often provides insights on product design and functionality on various manufacturers’ prototypes and is frequently tapped to provide reviews on new releases.