In The News

UnitedHealthcare to Revise Medical Policy on Obstructive Sleep Apnea Treatment

On March 1, 2024, UnitedHealthcare (UHC) will implement a groundbreaking revision to its obstructive and central sleep apnea (OSA) medical policy. This significant change now mandates oral appliance therapy as a crucial step before considering surgical treatment for adult patients diagnosed with moderate to severe OSA.


Under this new policy, patients must undergo a trial of an oral appliance, such as TAP, before UHC will provide coverage for procedures like Inspire Hypoglossal Nerve Stimulator. Surgical treatments, while having the potential to eliminate or improve OSA, are often expensive, invasive, and may not guarantee complete resolution. (Data? Ask Charles)


Various options exist for surgical procedures for OSA, such as Uvulopalatopharyngoplasty (UPPP), Trans Oral Robotic Surgery (TORS), Maxillomandibular Advancement (MMA) surgery, and Tonsillectomy. However, UHC emphasizes considering these surgical treatments only after the “failure of an adequate trial of oral appliance therapy.”


This shift in UHC’s policy significantly endorses oral appliance therapy, specifically TAP. It underscores that oral appliances are recognized as effective and viable treatment options for OSA patients seeking surgical interventions. This acknowledgment by UHC elevates the status of oral appliance therapy, placing it on par with the long-established reputation of CPAP therapy.


For years, TAP has proven itself as a safe and comfortable treatment option for patients with mild to moderate and, in some cases, severe OSA. Over 55+ studies support the efficacy of TAP, demonstrating its ability to manage sleep apnea symptoms effectively.


One notable development is the introduction of myTAP, a low-cost, non-custom oral appliance that aligns perfectly with UHC’s new policy. Independent peer-reviewed studies have shown that myTAP is equally effective as custom oral appliances, providing a cost-effective and accessible solution for patients.


The myTAP advantage extends further as dentists, physicians, and sleep clinics widely use it. Its ease of fitting, using a simple process involving boiling water and requiring no lab time, adds to the convenience and accessibility of this innovative oral appliance.


UHC’s revised medical policy represents a significant step forward for oral appliance therapy, validating its effectiveness and positioning it as a crucial treatment option for patients suffering from OSA.


As the landscape of sleep apnea treatment evolves, embracing oral appliance therapy as a primary step signifies a positive shift towards more accessible and patient-friendly interventions.