Sleep Conditions
Good night, sleep tight
Insufficient sleep is so common, the Centers for Disease Control has called it a public health problem.
Sleep isn’t just for beauty
Sleep deprivation is linked to car crashes, obesity, depression, hypertension, and diabetes. That’s why Premera offers coverage for sleep issues. If you feel tired even after getting 7 hours of sleep, your partner complains about your snoring, or you stop breathing at night, you might benefit from talking with a doctor about sleep disorders.
If you have concerns about teeth grinding, jaw clenching, sleepwalking, sleep terrors, bed wetting, limb movement, or other sleep disorders, talk to your primary care provider about treatment.
Sleep studies and sleep apnea
Sleep apnea is the most common disorder. It's characterized by pauses in breathing during sleep. It's also easy to diagnose and treat.
Your doctor might recommend a sleep study, which in many cases can be done in your home using portable equipment. If your study results show sleep apnea, your doctor might recommend a continuous positive airway pressure (CPAP) machine.
CPAP coverage
Premera provides coverage for CPAP machines and supplies when medically appropriate, but you will be required to rent a machine before you purchase one. Renting allows you to test machines and find the right one. It can take 4-6 months of working with your doctor to be properly fitted for equipment that you will use long term.
We require customers to use the CPAP device at least 70% of the nights in a 30-consecutive-night period for a minimum of 4 hours each night. This is to make sure the machine works for you, and you're feeling better.
If you're not using your CPAP as directed, contact your sleep specialist or equipment provider to identify or correct problems with using the machine. If you don't use your machine as required, Premera will stop paying for the rental and will no longer cover any supplies for the machine.
CPAP is the most effective treatment for sleep apnea, but you may choose to use an oral positioning device if you can't tolerate CPAP.
Frequently asked member questions
For Premera to cover your device, it needs to be approved before it's purchased. Work with your doctor to get this approval.
For most adults, we require a home sleep study first. For children and adults with certain conditions, a sleep facility is appropriate. We follow the American Academy of Sleep Medicine guidelines for sleep study procedure.
Renting allows you to try different equipment and find the right fit. We find that many people stop using their machines if it's not a good fit. If you don't use your equipment, you can't get the health benefits of a better night's sleep.
CPAP machines can be replaced after 5 years. The coverage requires a one-year, rent-to-own period with monitoring to check that you are getting benefit from the machine.
Your machine has monitoring technology that sends ongoing usage reports to your sleep provider, who shares that information with us.
Benefits under your health plan may differ, so refer to your benefit booklet for information on what your specific health plan covers.
Your health plan covers preventive care services as required by state and federal law. For more information, please review the "A" and "B" rated services on the United States Preventive Services Task Force, immunizations recommended by the Centers for Disease Control and Prevention and preventive care and screening recommended by the Health Resources and Services Administration. See the list on healthcare.gov.