Underwriting for Sleep ApneaJulie Brooks
One of the common underwriting concerns we see is Sleep Apnea, which is a potentially serious sleep disorder. Essentially, it is a disorder in which breathing repeatedly starts and stops. Millions are affected by this, with most cases being considered moderate to severe obstructive.
There are multiple types of Sleep Apnea…
- Obstructive: Occurs when throat muscles relax
- Central: The brain doesn’t send proper signals to the muscles that control breathing
- Complex: Both obstructive and central Sleep Apnea
Underwriting is handled differently depending on the type of coverage…
- Life: Commonly ranges from Standard to Table 3 when compliant with treatment plan
- Disability: If mild, the rating can range from Table 1 or 2 to a decline. If moderate, the rating can range from Table 2 or 3 to a decline. If severe, non-compliant with treatment, sleep study pending, or with a history of cardiac disease, chronic lung disease, or diabetes, it will generally be a decline.
- Medicare Supplement: To be approved, the client must be compliant with their treatment plan
- LTC: Standard/Select rating is common for mild cases where the client is compliant and has shown a period of stability, generally for at least 3 months. If moderate, the rating could be Standard to Individual Consideration if the client is compliant. If severe, and the client is compliant with treatment, Individual Consideration. If the client uses oxygen, has a sleep study pending, is non-compliant with their treatment plan, it will be a decline.
It is important to gather as much detail as possible from a client with Sleep Apnea…
- Specific diagnosis
- Date of diagnosis
- Current HT/WT
- Current medications
- Compliance with treatment
- Any other health conditions
Typical treatment options are use of a CPAP, BiPAP, or a dental device, or in some cases, surgery is needed.
For more information, please contact Kathy Brooks with Insurance Advisors.