Life insurance and sleep apnea

A sleep apnea diagnosis can lead a life insurance company to decline coverage. Even if you get coverage, the insurer may charge a higher rate with limited coverage. However, not all insurance companies view it the same way, and you might be able to get affordable life insurance by shopping around.

It all depends on how severe your sleep apnea is and how compliant you are with treatments, according to Ed Nigerman of the Colorado-based Hinerman Group, which specializes in impaired risk life underwriting.

One effective treatment is the use of continuous positive airway pressure (CPAP), which uses a mask and air pump to provide airflow during breath inhalation to prevent the collapse of the airway.

People who have a mild to moderate condition and no other risk factors and who undergo an effective treatment, such as CPAP, would not be assessed a surcharge for an existing medical condition and would be considered by some insurers for preferred plus classification.

When you're getting life insurance quotes, your rates will be set in part by your risk class. That's defined by an insurer's underwriting guidelines. (Your policy amount and length are the other pricing factors.) The better your risk class, the lower your premiums. A preferred plus classification means you pay less than if you received a preferred or standard risk classification.

If your medical records indicate that you should have a sleep study performed and you haven't done one, some life insurance companies will not consider you for a policy until you do. The test reveals respiratory patterns, chest muscle activity and oxygenation, among other things.

Health insurance and sleep apnea

Typically, with group health insurance, individual underwriting isn't performed. That's an advantage if you have sleep apnea. Previously, an insurer could deny you coverage if you had a pre-existing condition. However, the Affordable Care Act (ACA) ended that practice; pre-existing conditions can no longer be used to deny coverage or raise rates.

Individual insurance companies outside of the ACA marketplace will usually cover sleep apnea treatments regardless of pre-existing conditions, including common treatments like CPAP.

Health insurance finder tool

Have you become unemployed within the last 60 days and lost your health insurance?
lady with box
Back
Is health insurance available from your employer?
Back
men use laptop
Back
Do you have a spouse with access to an employer-sponsored plan?
Back
couple
Back
What is your age?
Back
three mens
Back Reset result
Our recommendation

COBRA

The Consolidated Omnibus Reconciliation Act, better known as COBRA, allows you to stay on your former employer's health insurance plan to bridge the gap until you get new coverage. COBRA is expensive, as you will pay the full premium without help from your employer. It should be considered a short-term solution.
Learn more about COBRA
You may also want to consider:
Back Reset result
Our recommendation blue shield
Back Reset result

How much is your annual household income?

$0 $250,000+

How many members are in your household?

Select
Back
family
Back Reset result
Our recommendation

Medicare

Most people over the age of 65 qualify for Medicare. Original Medicare includes Parts A and B, for medical and hospital care. Medicare Advantage plans, administered by private health insurers, are called Part C, and include everything in Parts A and B. Many Advantage plans also include extra benefits like vision, hearing and dental coverage. Medicare Part D, which covers prescription drugs, can be added to either option.
Medicare costs vary depending on which option you choose.
Learn more about Medicare costs.
Back Reset result
Our recommendation blue shield
family
Compare and Buy Health Insurance Quotes in minutes
Back Reset result
Our recommendation

Medicaid

You may qualify for Medicaid based on your income. Guidelines for eligibility differ by state. To find out if you qualify in your state, contact the local Medicaid office.
You may also want to consider an ACA plan. The ACA provides subsidies for lower-income people. Learn more:
Back Reset result
Our recommendation blue shield
family
Compare and Buy Health Insurance Quotes in minutes
Back Reset result
Our recommendation

Parent's employer-sponsored health insurance

You can stay on your parent's health insurance plan until age 26 under the Affordable Care Act. For most people, this is the cheapest option. A dependent usually costs less to insure than a spouse or an individual.
You may also want to consider:
Back Reset result
Our recommendation blue shield
Back Reset result
Our recommendation

Spouse's employer-sponsored health insurance

If your spouse can add you to their employer-sponsored plan, it will likely be more affordable than seeking coverage on your own. In most cases, coverage for a spouse is available, but not always.
You may also want to consider:
Back Reset result
Our recommendation blue shield
Learn more about each plan type
  • PPO
  • HMO
  • HDHP
  • EPO
Back Reset result
Our recommendation

Employer-sponsored health insurance

Health insurance through your employer is generally the most affordable option since employers pay a large portion of the monthly premium. If an employer-sponsored plan is available, it's likely the best choice. You may have more than one plan option to choose from.
You may also want to consider:
Back Reset result
Our recommendation blue shield
Learn more about each plan type
  • PPO
  • HMO
  • HDHP
  • EPO
Back Reset result
Employer plans are often one of these types of four plans. Click on each one to find out more.
  • PPO
  • HMO
  • HDHP
  • EPO

Preferred-provider Organization (PPOs)

  • Pay higher premiums with a lower deductible
  • You have access to more providers, but pay much more for health insurance
  • You don't want to choose a primary care physician
  • You don't want to get a referral
  • You want the ability to get out-of-network care
Preferred-provider organization (PPOs) plans are the most common type of employer-based health plan. PPOs have higher premiums than HMOs and HDHPs, but those added costs offer you flexibility. A PPO allows you to get care anywhere and without primary care provider referrals. You may have to pay more to get out-of-network care, but a PPO will pick up a portion of the costs.
Find out more about the differences between plans

Health maintenance organization (HMO)

  • Pay higher premiums with a lower deductible
  • Restricted network of providers with lower premiums
  • You want to choose a primary care physician
  • You don't mind getting a referral
  • You don't care about the ability to get out-of-network care
Health maintenance organization (HMO) plans have lower premiums than PPOs. However, HMOs have more restrictions. HMOs don't allow you to get care outside of your provider network. If you get out-of-network care, you'll likely have to pay for all of it. HMOs also require you to get primary care provider referrals to see specialists.
Find out more about the differences between plans

High-deductible health plans (HDHPs)

  • Pay lower premiums with a higher deductible
High-deductible health plans (HDHPs) have become more common as employers look to reduce their health costs. HDHPs have lower premiums than PPOs and HMOs, but much higher deductibles. A deductible is what you have to pay for health care services before your health plan chips in money. Once you reach your deductible, the health plan pays a portion and you pay your share, which is called coinsurance.
Find out more about the differences between plans

Exclusive provider organization (EPO)

  • Restricted network of providers with lower premiums
  • You don't want to choose a primary care physician
  • You don't want to get a referral
  • You don't care about the ability to get out-of-network care
Exclusive provider organization (EPO) plans offer the flexibility of a PPO with the restricted network found in an HMO. EPOs don't require that members get a referral to see a specialist. In that way, it's similar to a PPO. However, an EPO requires in-network care, which is like an HMO.
Find out more about the differences between plans
Back Reset result
green shield
family
Compare and Buy Health Insurance Quotes in minutes
Back Reset result
Individual insurance
You should compare individual insurance plans, including those on the health insurance exchanges created by the Affordable Care Act (ACA). ACA plans have no restrictions on pre-existing conditions and must include certain coverage basics.
Learn more about individual insurance plans
Back Reset result
blue shield
To learn more about ACA plans, choose the option that best fits your needs
Back Reset result
Individual insurance
The Affordable Care Act created insurance exchanges that allow people to compare plans. The health law also requires insurers to accept everyone and not charge them exorbitant rates. People who make below 400% of the federal poverty level qualify for subsidies to help pay for an ACA plan.
Know more individual insurance / ACA
These plans have lower monthly premiums and higher out-of-pocket costs
Back Reset result
silver shield

Silver plans provide a good balance of monthly premiums with out-of-pocket costs. Coinsurance is 70% with a silver plan, meaning you will pay 30% of the costs after your deductible is met, up to the out-of-pocket limit. Silver plans are a good choice for people who are in generally good health but don't want high out-of-pocket costs if something goes wrong.

Bronze plans are a popular choice with those who value low monthly premiums and are willing to pay more when they need care. Coinsurance is set at 60%, meaning you will pay 40% if you do need care, up to the out-of-pocket limit. Bronze plans are good for those who don't expect to need many services outside of preventative care throughout the year.

family
Compare and Buy Health Insurance Quotes in minutes
Back Reset result
Individual insurance
The Affordable Care Act created insurance exchanges that allow people to compare plans. The health law also requires insurers to accept everyone and not charge them exorbitant rates. People who make below 400% of the federal poverty level qualify for subsidies to help pay for an ACA plan.
Know more individual insurance / ACA
These plans have higher monthly premiums with lower out-of-pocket costs
Back Reset result
platinum shield

ACA platinum plans have the highest monthly premiums, but the lowest out-of-pocket costs. You'll pay more monthly in return for lower deductibles, copays and coinsurance amounts. Coinsurance with platinum plans is 90%, which means you pay 10% after the deductible, up to your out-of-pocket limit. Platinum plans are good for those who anticipate a lot of medical needs throughout the year.

Gold plans cost a little less than platinum plans, and come with higher out-of-pocket costs. The coinsurance amount on a gold plan is 80%, which means you pay 20% after the deductible, up to your out-of-pocket limit. A gold plan is a good idea if you think you'll need a lot of care throughout the year, but don't want to pay platinum premiums.

family
Compare and Buy Health Insurance Quotes in minutes

Sleep apnea and car insurance

Sleep apnea affects life and health insurance, but car insurance isn't directly impacted. However, if your sleep apnea causes you to drive poorly and get into accidents, you will face rate increases.

"Since fatigue is a factor in accidents, sleep apnea can put you indirectly at a higher risk of getting into a car accident," Scott Hoffman, an agent and principal of the Howard & Hoffman Insurance Agency says.

Sleep apnea is not a medical condition that, by itself, can result in being denied coverage by a car insurance company.

Continue reading