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Health insurance for sleep apnoea

You're in the right place to find health insurance for sleep apnoea. Comprehensive cover is available from private health funds. The cost of treatment for the breathing disorder can be partly met by Medicare.

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

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 $93,000 income and living in Sydney.

Name Product Treatments Price Apply
  • Joint reconstructions
  • Ear nose and throat
  • Blood
  • Back neck and spine
  • Dental surgery
  • Eye excluding cataracts
  • Cancer
  • Lung and chest
  • +18 other treatments covered
$91.11
per month
  • Joint reconstructions
  • Ear nose and throat
  • Blood
  • Back neck and spine
  • Dental surgery
  • Eye excluding cataracts
  • Cancer
  • Lung and chest
  • +18 other treatments covered
$99.25
per month
  • Joint reconstructions
  • Ear nose and throat
  • Blood
  • Back neck and spine
  • Dental surgery
  • Eye excluding cataracts
  • Cancer
  • Lung and chest
  • +18 other treatments covered
$112.56
per month
HCF HOSPITAL STANDARD SILVER PLUS
Silver Plus$750 excess
  • Lung and chest
  • Back neck and spine
  • Cataracts
  • Joint replacements
  • Blood
  • Dental surgery
  • Palliative care
  • Pregnancy and birth
  • +24 other treatments covered
$114.03
per month
Silver Plus Hospital 750
Silver Plus$750 excess
  • Lung and chest
  • Back neck and spine
  • Cataracts
  • Joint replacements
  • Blood
  • Dental surgery
  • Palliative care
  • Pregnancy and birth
  • +24 other treatments covered
$123.61
per month
HCF HOSPITAL STANDARD SILVER PLUS
Silver Plus$500 excess
  • Lung and chest
  • Back neck and spine
  • Cataracts
  • Joint replacements
  • Blood
  • Dental surgery
  • Palliative care
  • Pregnancy and birth
  • +24 other treatments covered
$125.11
per month
  • Lung and chest
  • Back neck and spine
  • Cataracts
  • Joint replacements
  • Blood
  • Dental surgery
  • Palliative care
  • Pregnancy and birth
  • +26 other treatments covered
$127.71
per month
Silver Hospital $750/$1500
Silver Plus$750 excess
  • Lung and chest
  • Back neck and spine
  • Cataracts
  • Joint replacements
  • Blood
  • Dental surgery
  • Palliative care
  • Pregnancy and birth
  • +24 other treatments covered
$133.10
per month
  • Lung and chest
  • Back neck and spine
  • Cataracts
  • Joint replacements
  • Blood
  • Dental surgery
  • Palliative care
  • Pregnancy and birth
  • +26 other treatments covered
$138.05
per month
Silver Hospital $500/$1000
Silver Plus$500 excess
  • Lung and chest
  • Back neck and spine
  • Cataracts
  • Joint replacements
  • Blood
  • Dental surgery
  • Palliative care
  • Pregnancy and birth
  • +24 other treatments covered
$138.91
per month
HCF HOSPITAL STANDARD SILVER PLUS
Silver Plus$250 excess
  • Lung and chest
  • Back neck and spine
  • Cataracts
  • Joint replacements
  • Blood
  • Dental surgery
  • Palliative care
  • Pregnancy and birth
  • +24 other treatments covered
$139.55
per month
Silver Hospital $200/$400
Silver Plus$200 excess
  • Lung and chest
  • Back neck and spine
  • Cataracts
  • Joint replacements
  • Blood
  • Dental surgery
  • Palliative care
  • Pregnancy and birth
  • +24 other treatments covered
$152.10
per month
Frank Max Hospital 750 (Silver+)
Silver Plus$750 excess
  • Lung and chest
  • Back neck and spine
  • Cataracts
  • Joint replacements
  • Blood
  • Dental surgery
  • Palliative care
  • Pregnancy and birth
  • +24 other treatments covered
$169.10
per month
Silver Plus Hospital $750
Silver Plus$750 excess
  • Lung and chest
  • Back neck and spine
  • Cataracts
  • Joint replacements
  • Blood
  • Dental surgery
  • Palliative care
  • Pregnancy and birth
  • +27 other treatments covered
$171.78
per month
  • Lung and chest
  • Back neck and spine
  • Cataracts
  • Joint replacements
  • Blood
  • Dental surgery
  • Palliative care
  • Pregnancy and birth
  • +26 other treatments covered
$174.38
per month
  • Lung and chest
  • Back neck and spine
  • Cataracts
  • Joint replacements
  • Blood
  • Dental surgery
  • Palliative care
  • Pregnancy and birth
  • +27 other treatments covered
$178.45
per month
  • Lung and chest
  • Back neck and spine
  • Cataracts
  • Joint replacements
  • Blood
  • Dental surgery
  • Palliative care
  • Pregnancy and birth
  • +27 other treatments covered
$179.16
per month
Silver Plus Hospital $750/$1500
Silver Plus$750 excess
  • Lung and chest
  • Back neck and spine
  • Cataracts
  • Joint replacements
  • Blood
  • Dental surgery
  • Palliative care
  • Pregnancy and birth
  • +27 other treatments covered
$180.26
per month
  • Lung and chest
  • Back neck and spine
  • Cataracts
  • Joint replacements
  • Blood
  • Dental surgery
  • Palliative care
  • Pregnancy and birth
  • +27 other treatments covered
$180.90
per month
Silver Plus Hospital $500
Silver Plus$500 excess
  • Lung and chest
  • Back neck and spine
  • Cataracts
  • Joint replacements
  • Blood
  • Dental surgery
  • Palliative care
  • Pregnancy and birth
  • +27 other treatments covered
$181.44
per month
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