Coverage varies depending on your plan and policy. If you qualify, you typically can expect to pay any unmet deductible for the year, along with any copay or coinsurance fee your insurance plan requires.
Body mass index (BMI) is another important factor in determining coverage for Inspire therapy. Some basic BMI related qualification considerations are as follows.
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.
If you meet the FDA indications for Inspire therapy and your BMI is between 32-35, 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.
If you meet the FDA indications for Inspire therapy and your BMI is above 35, getting coverage for Inspire from your insurance provider may be more difficult, but there may be options. Talk to your insurance provider or Inspire therapy-trained doctor to learn more.
* 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.
An Inspire therapy-trained doctor also can talk to you about insurance coverage during your initial Inspire therapy consultation appointment.Find a doctor