Does Medicare Cover Insomnia Treatment?
Have you ever had one of those nights where no matter what you do, you couldn’t fall asleep? You lay in bed staring at the ceiling hoping to drift off, but you just can’t? Not to mention all of this is followed by inevitable exhaustion. Now imagine feeling like this most nights. This is the reality for up to a quarter of Americans every year who develop chronic insomnia.
Figuring out why you’re having trouble sleeping, treating the root causes and dealing with insomnia can get expensive. If you’re enrolled in Medicare, do you have any coverage for both insomnia diagnosis and treatment?
What is Insomnia?
Simply put, insomnia is the inability to fall asleep or stay asleep. It can be acute, meaning a single night or short-term sleep issues, to chronic or long-term. Generally, for insomnia to be chronic, it needs to be consistent for up to three nights a week for at least three months or more. Insomnia may also be primary or secondary, depending on if it’s linked to another health condition or not.
You could even notice that you’re having sleep issues, but if you find yourself not feeling well rested in the morning, tired throughout the day, or generally irritable, depressed, or anxious, those are signs you should seek a doctor’s help.
General symptoms of insomnia can include trouble falling asleep or anxiety about not being able to fall asleep. You may also find yourself waking up in the middle of the night and struggling to fall back asleep. You could even notice that you’re having sleep issues, but if you find yourself not feeling well rested in the morning, tired throughout the day, or generally irritable, depressed, or anxious, those are signs you should seek a doctor’s help.
Medicare and Insomnia Testing
Determining what type of insomnia you have is critical to preventing or treating it. The causes of insomnia can be varied from sleep environment and stress to secondary health concerns. Each of these require a different avenue of treatment. If you’re experiencing signs of insomnia, we encourage you to talk to your doctor during your Annual Wellness Visit or schedule an appointment. They may help you figure out the cause then and there or refer you to a sleep specialist to find answers.
If you’re experiencing signs of insomnia, we encourage you to talk to your doctor during your Annual Wellness Visit or schedule an appointment.
If you show the clinical signs of sleep apnea, insomnia being one, you may also qualify for coverage for a Type 1 sleep study through Medicare. Your doctor must order the test. A sleep study, also called a polysomnography, will check for signs of a sleep disorder and the severity of it. While you must show signs of sleep apnea to have the test covered, they may find you have a different sleep disorder, like narcolepsy or unexplained chronic insomnia. Either way, you may get answers.
Medicare Coverage of Insomnia Treatment
Once you figure out what’s causing your insomnia, you can find a treatment plan with your doctor. You’ll likely be instructed to create a healthier sleep environment in your bedroom, making it easier to drift off. Beyond that, you’ll have a number of cause-specific routes to try.
If your insomnia is part of an overall sleep apnea diagnosis, you’ll likely qualify for Medicare coverage of a CPAP machine. These machines keep your airways open and help you get a more restful sleep.
Another common cause of insomnia is mental health issues from anxiety to depression and beyond. If this is you, your best course of action will be to talk with a mental health professional or therapist to begin working through these issues. Luckily, Medicare can help pay for mental health costs through Medicare Part B for outpatient mental health services or Part A for inpatient stays at a mental health care facility.
While it’s usually not the first option when it comes to insomnia care, you may be instructed to try a sleep aid or medication. This may include over-the-counter options like melatonin or an antihistamine. You may also be prescribed zaleplon (Sonata) or zolpidem (Ambien). If you’re enrolled in Medicare Part D or a Medicare Advantage plan with prescription drug coverage, you may have coverage depending on your plan’s formulary. If it’s not covered, you may be able to file an exception to request coverage of the drug.
● ● ●
A bad night’s sleep can ruin the next day, leaving you groggy, uncomfortable, and grumpy at the best of times. When this issue has been going on for days, weeks, months, or even longer, the risks are multiplied. If you’re struggling to sleep at night or to have restful sleep, don’t wait. Talk to your doctor to figure out what’s going on so you can solve the issues and get a good night’s rest.
- Medicareful Travel: Senior Trip to Lucerne
- Is Expensive Cookware Worth It?
- The Drug Prices Medicare Can Directly Negotiate
- Does Medicare Ever Cover Cosmetic Surgery?
- Medicareful Travel: Senior Trip to Barcelona
- How Does COBRA Work with Medicare?
- Different Ways Medicare Can Cover Drug Costs
- All About Enrolling in Social Security
- Medicareful Travel: Senior Trip to the Madrid
- Does Medicare Cover Open-Heart Surgery?
- Exercise Tips for Summer
- Medicareful Travel: Senior Trip to Lisbon
- Hosting a Safe Summer Barbecue
- Senior Summer Barbecue Tips
- Does Medicare Cover Biopsies?
- 5 Foods to Avoid if You Have High Blood Pressure
- Medicareful Travel: Senior Trip to the Finger Lakes
- Does Medicare Cover Endoscopies?
- Ways Seniors Can Recover from a Workout
- Is Chocolate Healthy for You?
- Understanding Adult ADHD
- How Does Medicare Cover Hypertension?
- The Symptoms and Treatment of Parkinson's Disease
- How to Determine What Temperature to Use When Cooking
- Eating Healthy on a Budget
- Keeping Fit on Vacation
- Is Your Tonsillectomy Covered by Medicare?
- Tips for the Perfect Hard-Boiled Eggs
- Kitchen First Aid Tips
- What Does FDA-Approved Mean?
- Medicareful Travel: Senior Guide to New York City
- How to Caramelize Onions
- Why Do We Celebrate That? April Fools’ Day
- Medicare and Powers of Attorney
- The Essential Role of Eggs in Cooking
- What are Different Types of Complementary
and Alternative Medicine?
- Tips for Remembering to Take Your Medicine
- What is Medicare Part E?
- Building Your Basic At-Home Senior Gym
- How to Make Stovetop Popcorn
- Medicareful Travel: Senior Trip to New Orleans
- How to Navigate & Read Academic Articles
- Phytonutrients: What Plant Color Says About Nutrition
- How to Prevent or Reduce Inflammation
- Osteoporosis: Risk Factors, Signs, and Treatment
- How to Make Homemade Pretzels
- Researching Your Ancestry and Family Tree
- How Medicare and Social Security Work Together
- What is Nordic Walking?
- Food Questions You've Been Embarrassed to Ask
- How Medicare Changed for 2023 and Beyond
- Tips for Using a Microwave
- How to Clean Your Ears Safely
- Skiing as a Healthy Hobby for Seniors
- 3 More Great Places to Celebrate New Year's Eve
- Why Do We Celebrate That? More New Year's Eve Traditions
- Panettone, the Italian Christmas Dessert
- A Simple Homemade Gingerbread Recipe
- How to Make Christmas Decorating Jollier
- The Science of Winter Weight Gain
- Seasonal Picks: 3 Foods You Should Try This Winter
- 5 Tips to Make Getting Your Christmas Tree Stress-Free
- Show-Stopping Potato Side Dishes for Thanksgiving
- Dishes to Impress Your Friends: Boeuf Bourguignon
- Holiday Travel Tips to Reduce Stress
- Does Medicare Cover Pain Management?
- Is Hunting a Healthy Senior Hobby?
- Ways You Can Get More Politically Involved
- What are Medicare's Lifetime Reserve Days?
- Spooky Spots for Seniors Halloween 2022
- How to Make Soul Cakes for Halloween
- Jack O' Lantern Carving Tips for Halloween
- Easy Ways to Peel a Potato
- 2023 Social Security COLA Largest in Decades
- Exercise Tips for Autumn
- How to Make Candy Apples at Home
- Why are Medicare Insurance Sales Calls Recorded?
- Here's What Medicare Costs in 2023
- CMS Updates Medicare Enrollment Rules for 2023
- Medicareful Travel: Senior Trip to London
- Does Medicare Cover Insomnia Treatment?
- Healthy and Easy Homemade Dog Treats
- The FDA Finalizes Ruling to Increase Access to Hearing Aids
- What the Inflation Reduction Act of 2022 Means for Medicare
- Tips to Make Flying and Airports Less Stressful
- CMS Projects Lower 2023 Part D Average Costs
- The 15 Golden Rules of Airplane Etiquette
- How Often Should You Shower?
- What are Medicare Pilot Programs?
- How to Care for Your Cast Iron Cookware
- Confronting a Loved One About Hurtful Behavior
- What Does Creditable Coverage Mean for Medicare?
- Using Za'atar in Your Cooking
- Dealing with Canceled Flights
- Protecting Your Vacation from Flight Disruptions
- Do Pre-Existing Conditions Affect Medicare Coverage?
- Which is Better: A Bath or Shower?
- Are Weight Loss Medications Healthy?
- Healthy Strategies for Anger Management
- The Health Benefits of Omega-3 Fatty Acids
- The Difference Between Common Cooking Papers and Foils
- What are Medicare I-SNPs?
- Identifying Toxic Relationships in Your Life
- Healthy Ways to Spice Up Your Water
- All About Medicare Dual Eligible Special Needs Plans
- Medicareful Travels: A Senior Guide to All-Inclusive Resorts
- Does Medicare Cover Occupational Therapy?
- Lower 2023 Medicare Part B Premium Could Be on the Way
- Which is Better: Natural or Artificial Sweeteners?
- Tips for Vacationing with Pets
- Is It Better to Work Out Harder or Longer?
- Tips for Traveling with Your Pet
- Are Medicare Part B Giveback Plans Worth It?
- Introducing the Medicareful Living Family Cookbook!
- Medicare Coverage for Treatment of PTSD
- The Causes and Treatments of Nasal Congestion
- Dishes to Impress Your Friends: Spring Rolls
- Medicare Freezes Late Enrollment Penalties for Qualifying Enrollees
- What is a 5-Star Medicare Plan?
- What is PTSD?
- What is Inflammation?
- What is Medicare's Secondary Payer Program?
- What You Should Know When Buying Cast Iron Cookware
- What Does MACRA Mean for You?
- What to Do If You Receive a Terminal Diagnosis
- Dishes to Impress Your Friends: Homemade Lobster Ravioli
- Reading and Understanding Your Blood Pressure
- How to Be a Snowbird in Retirement (18 Questions to Ask!)