You can find some benefits for sleep apnoea starting in bronze hospital policies, sometimes referred to as "sleep studies".
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These products offer a balance between low pricing and more features.
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Usually these products would either have fewer treatments covered or higher pricing.
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Offering basic cover with limited features or higher pricing.
What is sleep apnoea?
Sleep apnoea is a disorder that occurs when a person's breathing is repeatedly interrupted during sleep. It can be a serious affliction as it restricts the body of its regular oxygen levels, and can impact long-term health in some cases.
What are the symptoms of sleep apnoea?
An 'apnoea' is the time when your breathing stops, and it can last anything from 10-90 seconds. While it is often hard to distinguish sleep apnoea from other sleeping problems, there are a few recognisable symptoms that you will feel consistently:
Waking up choking or gasping
Waking up with a sore or dry throat
Loud snoring
Sleepiness or lack of energy during the day
Headaches, especially in the morning
Forgetfulness and mood changes.
If you suspect you may have sleep apnoea, it's important to speak with your GP. They may refer you to a sleep physician for a test, known as a sleep study. This can confirm if you have sleep apnoea, or another sleep problem such as insomnia or narcolepsy.
How does Medicare cover sleep apnoea?
Before you can receive a Medicare rebate for a sleep study test, your doctor will need to make sure you are eligible by asking a series of approved screening questions. This is in order to make sure you definitely have a sleep disorder and are not being misdiagnosed.
Medicare may also cover Continuous Positive Airway Pressure (CPAP) therapy if you've been diagnosed with sleep apnoea. Your doctor will determine if you are eligible for CPAP based on how effective they feel the therapy may be in your situation.
Although Medicare will cover some of the costs, you'll still have out-of-pocket expenses. These can add up each time you receive care.
How does private health insurance cover sleep apnoea?
Treatment options vary depending on your insurer, but generally private health cover can help with the following:
Basic, Bronze or Silver policies
Taking part in an overnight sleep study at a hospital or clinic, in order to properly diagnose sleep apnoea.
As well as diagnosis, you'll get to choose your own doctor and hospital.
Some policies will pay a benefit towards the high cost of purchasing a CPAP machine and masks, if your doctor recommends CPAP therapy.
Silver Plus or Gold policies
Taking part in an overnight sleep study at a hospital or clinic, in order to properly diagnose sleep apnoea.
As well as diagnosis, you'll get to choose your own doctor and hospital.
Some policies will pay a benefit towards the high cost of purchasing a CPAP machine and masks, if your doctor recommends CPAP therapy.
More comprehensive cover could help with alternative treatment, such as nasal surgery or a tonsillectomy.
Some policies may cover a home sleep test. According to SleepFoundation.org, the accuracy of home sleep tests for apnoea can range from 68% to 91%.
It's also worth remembering you should always get the Medicare Benefits Schedule (MBS) number from your doctor. This lets you know exactly what you'll pay, so you are able to budget well in advance of treatment.
Compare health insurance with sleep apnoea coverage
We crunched through the policies and here are some policies from Finder partners that offer a benefit for sleep apnoea or sleep studies. To compare even more funds, use the free tool below the table. All prices are based on a single individual with less than $97,000 income and living in Sydney.
Finder Score - Hospital cover health insurance
Each month we analyse over 10,000 hospital insurance products and rate each one on price and features. What we end up with is a nice round number out of 10 that helps you compare hospital cover a bit faster.
Before we start scoring, we need to make sure we're comparing like-for-like. Just as it doesn't make sense to compare a bicycle with a Ferrari, it doesn't make sense to compare basic hospital policies to top-tier Gold policies. Each policy is given a price score and feature score. These are then combined to determine each policies's Finder Score.
Depending on your age, you may be eligible for an
aged-based discount. This is used to estimate your
rebate.
Under 65
65 - 69
70 or older
What's your household's taxable income?
This is the combined income you and your spouse earn before tax. It's needed to calculate the correct Australian government rebate.
$93,000 and under
$93,001 to $108,000
$108,001 to $144,000
$144,001 and over
What kind of health insurance do you need?
Combined (Extras + Hospitals)
Extras
Hospital
What level of hospital coverage would you like?
You can change this at any time later.
Legend
Covered
Restricted cover, You may be partially covered for
this category.
Not covered. Optional for insurer to include.
*Prices updated March 2024, in line with Finder's
database of health insurance policies. Prices are based
on a single individual with less than $93,000 income and
living in Sydney with a $750 excess.
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Select as many as you want or move to the next step
Preventative & general dental
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Frequently asked questions
A range of factors can contribute to sleep apnoea. Risk factors include having a small chin or a facial deformity. An underactive thyroid, large tonsils or adenoids are also factors.
Unhealthy lifestyles can also contribute towards people getting sleep apnoea. For example, Excessive alcohol consumption or smoking can increase your risk.
Yes. In order to find out if you're suffering from sleep apnoea, you can get a sleep test, or sleep study. Doctors will monitor things like your heart rate, blood pressure and oxygen levels. Your doctor usually prescribes the tests, which involve you spending a night in hospital so you can be properly monitored.
Most commonly, you'll receive breathing apparatus, such as a continuous positive airway pressure machine (CPAP), which will assist your night-time breathing. This prevents you from snoring and, more importantly, makes sure you're breathing properly. It also helps ensure you're getting enough oxygen to your brain. You may also receive weight loss and physical exercise help.
Depending on your cover and condition, you may also receive help from a respiratory therapist, otolaryngologist or pulmonologist. This can often involve taking medication – including sleep medication – and surgery in some cases.
Gary Ross Hunter was an editor at Finder, specialising in insurance. He’s been writing about life, travel, home, car, pet and health insurance for over 6 years and regularly appears as an insurance expert in publications including The Sydney Morning Herald, The Guardian and news.com.au. Gary holds a Kaplan Tier 2 General Advice General Insurance certification which meets the requirements of ASIC Regulatory Guide 146 (RG146). See full bio
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Gary Ross has written 644 Finder guides across topics including:
James Martin was the insurance editor at Finder. He has written on a range of insurance and finance topics for over 7 years. James often shares his insurance expertise as a media spokesperson and has appeared on Prime 7 News, WIN News, Insurance News, 7NEWS and The Guardian. He holds a Tier 1 General Insurance (General Advice) certification and a Tier 1 Generic Knowledge certification, both of which meet the requirements of ASIC Regulatory Guide 146 (RG146). See full bio
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Accessing treatment from one of your health fund’s preferred providers can help you save money but can also limit your health care choices. Find out more here.
Health insurance for weight loss surgery starts at around $62 a week with gold-tier hospital policies. It comes with a 12-month waiting period, so it's worth getting sooner rather than later.
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Depending on your age, you may be eligible for an
aged-based discount. This is used to estimate your
rebate.
Under 65
65 - 69
70 or older
What's your household's taxable income?
This is the combined income you and your spouse earn before tax. It's needed to calculate the correct Australian government rebate.
$93,000 and under
$93,001 to $108,000
$108,001 to $144,000
$144,001 and over
What kind of health insurance do you need?
Combined (Extras + Hospitals)
Extras
Hospital
What level of hospital coverage would you like?
You can change this at any time later.
Legend
Covered
Restricted cover, You may be partially covered for
this category.
Not covered. Optional for insurer to include.
*Prices updated March 2024, in line with Finder's
database of health insurance policies. Prices are based
on a single individual with less than $93,000 income and
living in Sydney with a $750 excess.
What extras cover do you need? (Optional)
Select as many as you want or move to the next step
Preventative & general dental
Major dental & implants
Optical
Physiotherapy
Podiatry
Non-PBS pharmaceuticals
Chiropractic
Emergency ambulance
Remedial massage
Email me my results (optional)
To get a copy of your results for later, add your email below
