What Type of Health Service is a Sleep Study?

[ripVanWinkle]

Hi insurance experts (hopefully). I am trying to select an ACA ("Obamacare") insurance company. There is a dizzying amount of health insurance terms that I can't understand. But mostly, I want to know how much of a sleep study for obstructive sleep apnea related issues a policy covers.

I've had policies in the past which covered lots of things, but specifically excluded them if they were sleep disorder related. I gather that may not be an issue anymore. Right? So I don't have to call each insurer and ask if that's covered (because God knows I can't understand the stuff posted on healthcare.gov).

But then the policies cover different different amounts for seeing specialists, in-patient and out-patient services. They have rates for x-rays and diagnostic imaging, and all kinds of other stuff. But none of it seems to describe a sleep study.

A sleep study is done in a hospital, but you don't see the doctor there. Also, it doesn't even have to be a hospital, it could be a sleep clinic. Is it inpatientor outpatient?

It is diagnostic (I guess, sometimes), but it's not imaging. Lab and outpatient professional services seems the closest, but the study is not outpatient because you stay overnight.

So what is a sleep study? What type of service is it to see a sleep study doctor (who I think is a pulmonary-something-or-other-ogist)?

Also, does it vary by insurance company? Does one company put sleep study in "lab and outpatient" while another calls it "diagnostic"?

P.S. Please don't suggest that I should call the insurance companies. They're not open, I'm short on time, and they never answered similar questions when I've called them in the past.

 

[somarco]

Have you tried an insurance agent in your state that is familiar with plans and can advise you?

 

[GreenSky]

Have you tried an insurance agent in your state that is familiar with plans and can advise you?

He's short on time. Didn't you read his post?

Not everyone realized that this was even available prior to xmas..

Rick

 

[ripVanWinkle]

Have you tried an insurance agent in your state that is familiar with plans and can advise you?

I have not. I didn't even know they exist. Where do I find them (in NJ)?

 

[goillini52]

Have you tried an insurance agent in your state that is familiar with plans and can advise you?

Maybe he saw on your signature that you only charge 5 cents.

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I have not. I didn't even know they exist. Where do I find them (in NJ)?

On some companies websites, they have a place to click on to "find an agent".

 

[Yagents]

Agents are too expensive to hire. Do they take visa?

 

[ripVanWinkle]

Agents are too expensive to hire. Do they take visa?

It hardly matters what they take. They seem to be big health organizations, like hospitals, who don't work for me.

 

[Yagents]

U r clueless. Find an agent on this forum before u hurt yourself

 

[pcbinsurance]

Interesting. Rip Van Winkle is asking about sleep studies.

Irony? I think so.

 

[unic.consulting]

So to actually answer your question:

Sleep studies are usually considered out-patient procedures. Even though you're spending the night in the lab, you are not being admitted to the hospital. It is done under the care of a pulmonologist or neurologist, and most often it requires a prior authorization that is fairly easy to get after you see your PCP and discuss your symptoms with them.