Skip to main content

Rest assured, most U.S. insurers cover Inspire® therapy

Don’t let concerns about insurance coverage keep you from getting better sleep.1

How much does Inspire® therapy cost?

Different plans can result in varying out-of-pocket expenses. Inspire does not verify benefits or quote out of pocket costs. Review the below examples shared by Inspire Patient Ambassadors on how much they paid out-of-pocket for Inspire® therapy.

The patient testimonials & sleep apnea treatment reviews above relate to accounts of an individual’s response to treatment. The accounts are genuine, typical & documented. Responses to the treatment can & do vary. Insurance coverage and costs vary with each insurance plan. Inspire does not guarantee any third-party coverage or payment for our products or reimburse customers for claims that are denied by third party payors. Always talk with your doctor about diagnosis and treatment information.

Coverage: What to expect

The vast majority of U.S. insurance providers – including Medicare, Veterans Affairs (VA) and major commercial carriers – cover Inspire therapy for those who have tried and struggle with CPAP.

If you have U.S. commercial insurance or Medicare Advantage, it’s best to check directly with your insurance company to confirm your coverage information for Inspire therapy. Here’s a suggested way you may ask your insurance agent:

“I am considering Inspire therapy to help treat my sleep apnea. I would like to understand if my health insurance plan would cover the procedure, and if my clinic is in network. The code for the procedure is 64582, and it would be billed with a diagnosis code of G47.33. My clinic is [state your clinic here]."

Eligibility requirements

To be a candidate for Inspire therapy, you must meet the following FDA indications:

  • Age 18 or older

  • Diagnosed with moderate to severe obstructive sleep apnea

  • Have tried and struggle with CPAP

Inspire Therapy has been clinically tested for people with a body mass index (BMI) up to 40. Over 90%1 of U.S. adults are within this range. Most insurance policies have a BMI policy in place for Inspire therapy coverage. Talk to your provider or Inspire therapy-trained doctor for more information.

Inspire therapy is FDA-approved for use in pediatric patients with Down syndrome. Learn more about specific qualifications here.

The image shows a simple icon of a gauge with an indicator pointing to the left side, along with the text "<32" below it.
BMI below 32

If you meet the FDA indications for Inspire therapy and you have a BMI below 32, your insurance company is very likely to pay for Inspire therapy.

BMI 32-40

If you meet the FDA indications for Inspire therapy and your BMI is between 32-40*, it’s likely your insurance will pay for Inspire therapy. This may or may not require a prior authorization process that your clinic and/or the Inspire team can conveniently manage for you.

*Medicare plans require a BMI less than 35.

Don't know your body mass index?

Take a simple 5-question quiz to find out if you qualify and calculate your BMI.

* Please note: Our Inspire Medical Systems, Inc. team is actively pursuing updates to coverage policies. Inspire therapy has been clinically tested for people with a BMI up to 40 – the vast majority2 of U.S. adults are within this range.

Learn more about your specific plan

Talk to your insurance provider for more information about your policy and to get an estimate of what your out-of-pocket costs may be.

An Inspire therapy-trained doctor also can talk to you about insurance coverage during your initial Inspire therapy consultation appointment.

Find a doctor
1 Woodson BT, Strohl KP, Soose RJ, et al. Upper Airway Stimulation for Obstructive Sleep Apnea: 5-Year Outcomes. Otolaryngology Head Neck Surgery 2018; 159(1):194-202
2 “Overweight & Obesity Statistics - Niddk.” National Institute of Diabetes and Digestive and Kidney Diseases, U.S. Department of Health and Human Services, Sept. 2021.