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.
Insufficient sleep is so common the Centers for Disease Control has called it a public health problem. Sleep deprivation is linked to motor-vehicle crashes, obesity, depression, hypertension, and diabetes.
Sleep apnea is the most common disorder. It's characterized by pauses in breathing during sleep. It's also easy to diagnose and treat, which is important because people with untreated sleep apnea are at risk of falling asleep while driving, and have an increased risk of future heart attack, high blood pressure, irregular heartbeat, or stroke.
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.
Premera provides coverage for CPAP machines and supplies when medically appropriate, but you will be required to rent a machine before you purchase. Renting first ensures you get the right machine for you and that you will be willing and able to use it. It can take 4-6 months of working with your doctor to be properly fitted for equipment that you will use longterm.
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 on those
nights. This is to make sure the machine works for you, and you're feeling
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 don't tolerate CPAP.
If you have concerns about teeth grinding, jaw clenching, sleepwalking, sleep terrors, bed wetting, limb movement, or other sleep disorders, please talk to your primary care provider about treatment.
For Premera to cover your device, it needs to be approved before purchase. 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 Society for Sleep Medicine guidelines for sleep study procedure.
Renting allows you to try different equipment and find the right fit for you. 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.
Please note: Benefits under your health plan may differ, so refer to your benefit booklet for information on what your specific health plan covers. This is general information about benefits and coverage; actual benefits depend on your benefit plan and eligibility on the date of service.
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