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Insurance Benefits For Military Personnel

The US Department of Veterans Affairs/Department of Defense (VA/DoD) just released  updated 2025 clinical practice guideline for obstructive sleep apnea (OSA)

TRICARE insurance can significantly help military personnel who have sleep apnea by covering diagnosis, treatment, and ongoing care. Here’s how:

1. Diagnostic Testing Coverage

TRICARE covers sleep studies (including in-lab polysomnography and at-home sleep tests) when medically necessary and ordered by a physician. This is crucial for confirming a sleep apnea diagnosis.

2. Oral Appliance Therapy

  • TRICARE recommends for mild to moderate OSA, either mandibular advancement devices (MAD) or positive airway pressure (CPAP) as first-line therapy options.
  • TRICARE covers Oral appliance therapy  on patient  prefers  as first line of therapy  or  unable to tolerate CPAP therapy prescribed by Physician.
  • Replacement of Oral appliance is based on medical necessity every 3-5  years
  • Tricare covers Positional Therapy for Positional OSA.

3.Surgical Options

For cases where non-surgical treatments fail, TRICARE may cover procedures like:

  • Uvulopalatopharyngoplasty (UPPP)
  • Inspire (hypoglossal nerve stimulation), with prior authorization

4. Ongoing Medical Care

TRICARE covers Oral appliance therapy, follow-up visits and monitoring to ensure the treatment is effective, which is essential for compliance and long-term health outcomes.

5. Ongoing Medical Care

TRICARE covers follow-up visits and monitoring to ensure the treatment is effective, which is essential for compliance and long-term health outcomes.

6. Health Impact for Active Duty

Proper management of sleep apnea through TRICARE helps ensure active-duty service members:

  • Maintain readiness and cognitive performance

  • Avoid complications like high blood pressure, heart disease, or fatigue-related accidents

Would you like a version of this explanation tailored for a dental sleep medicine office or for a patient-facing handout?

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