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Does Health Insurance Cover Sleep Consulting Services?

A sleep consultant can significantly help when tackling sleep issues that have plagued you or your child for an extended time. However, the costs may only be affordable for some with the assistance of health insurance coverage, which typically does not cover unregulated, non-medical services. The good news is that a sleep consultant can be covered by specific plans, which may also help with your taxes. In this article, we'll delve into sleep consulting, the requirements, how it can be covered by health insurance, and how to ensure you'll get sleep consulting at the most affordable rate.

What is sleep consulting?

Sleep consulting is a field that employs a non-medicinal approach to addressing sleep problems. Many seek sleep consultants to help with their children's sleep issues, as this service can significantly benefit parents and their young children. A sleep consultant helps implement strategies that can alleviate recurring sleep problems. Sleep consulting consists of:

  • An initial consultation in which the sleep consultant gathers information about the client. This can be in person, over the phone, or online.
  • A written sleep plan based on information obtained through the initial consultation. Individuals can refer to this written plan as they begin incorporating the sleep consultant's suggestions.
  • Continued correspondence with the sleep consultant to track progress. If a particular strategy isn't working, a sleep consultant may suggest an alternative method to deliver better results.

While sleep consulting is typically geared toward babies, it's also a viable service for children of all ages, including teens.

Sleep consultation coverage in health insurance

The sleep consulting industry isn't regulated, but that's not to say it doesn't have a standard that sleep consultants must adhere to. Those looking to become sleep consultants are educated on the morality and ethics of sleep consulting services, the scientific and psychological aspects of sleep, and the factors affecting sleep quality.

Although it's an unregulated field, sleep consulting is an area of expertise where one can earn a certification. Numerous institutions provide courses for certification in sleep consulting. The coursework is relatively extensive — it's not a certification that can be achieved in a few weeks. Becoming a sleep consultant can take roughly six months if the individual devotes about eight hours per week to studying the course material.

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Can health insurance cover a sleep consultant's services?

Since this is an unregulated industry and the services are non-medical, it's doubtful that most health insurance policies would cover seeing a sleep consultant. Sleep consultants may refer clients to medical practitioners whose services would be covered by insurance if the sleep consultant feels that there is an issue beyond their expertise. Likewise, a medical provider like a pediatrician may refer a patient to a sleep consultant if they think a sleep issue can be resolved by correcting behaviors rather than medical intervention.

Despite sleep consulting being absent from many forms of health insurance coverage, some insurance plans are more lenient regarding coverage — namely Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs). With these plans, you may be able to use your account funds to cover costs related to sleep consulting.

How do HSAs work?

HSAs allow tax-free contributions to an account designed to pay out-of-pocket medical expenses (e.g., coinsurance, copayments, and deductibles). Individuals can get HSAs if they are enrolled in a high-deductible health plan. Such plans can be found through the Health Insurance Marketplace, Small Business Health Options Program (SHOP), and elsewhere. High-deductible health plans can also be available through employer-sponsored plans.

In 2024, you can contribute upwards of $4,150 per year if you're insuring yourself only and $8,300 per year for a family plan. If you don't use all of the funds over the course of the year, they will carry over into the next year. Unused funds may also be invested for growth. This type of spending account can help save on medical costs and taxes.

What health insurance providers may provide coverage for sleep consulting?

You can enroll in an HSA through a bank or credit union if you have a high-deductible health plan.

You can also get it through health insurance companies, such as:

  • Blue Cross Blue Shield
  • Cigna

Or, you may opt to get it from an HSA company, such as:

  • Lively
  • Fidelity

While these providers offer HSA plans, it should be noted that not all plans in all regions are precisely the same regarding coverage. Each policy is different, so it is better to discover whether it covers a particular service than to purchase it and find that the service you need will not be covered. This isn't just true for sleep consulting but for any type of service that insurance may or may not cover.

Alternative financing options

If your insurance coverage does not apply to sleep consulting services, you still have options to make sleep consultations more affordable. Although service packages can be as much as $1,000, some sleep consultants will take installments instead of paying all expenses upfront. It's also important to consider that many sleep consultants are self-employed. Given this, they may be able to tailor their costs to meet your budget needs at their discretion, as they can set their rates.

Another route may be to select an option for a shorter duration of sleep counseling services with fewer features. For instance, a low-cost purchase may include a basic sleep plan with limited email correspondence with the consultant. In contrast, a more expensive choice would be a sleep plan in addition to 24/7 access to consultants via text for a week and access to training calls. If your insurance doesn't cover sleep consulting, you can choose the lowest-cost option to get sleep consultations without it being hard on your budget.

Tips on the documentation process

It's best to keep a record for several reasons, especially considering that a lack of documentation can cause issues later. There are some steps to take to ensure that you can get sleep consulting services covered by insurance:

  • Obtain a letter of medical necessity. This is particularly useful when a medical professional refers you to a sleep consultant. A letter of medical necessity is a document sent from your medical provider to your insurer that justifies the need to cover a specific item related to a medical condition.
  • Contact your plan's administrator. When you contact your plan's administrator, you can get a detailed list of all the paperwork you need so that your sleep consultations will be covered.
  • Keep all paperwork and receipts. Having all records and invoices will protect you in case you are audited. This way, you can prove that your sleep consultation was covered by insurance and not subject to tax penalties.
  • Track your contributions and distributions. This will help you when it comes time to file taxes.

Why you should check coverage regularly

If you're paying using an HSA or FSA, it's important to review the terms of your policy's coverage to ensure that you won't be subject to any penalties if you continue to use your policy's funds to cover sleep consulting costs. You can find this out by contacting your plan administrator directly or by looking at your plan's Summary of Benefits and Coverage. This will let you know what is and isn't covered.

If your policy no longer covers sleep consultations, you may find yourself having to pay all costs out-of-pocket. If you're enrolled in an HSA, you could face a 20% tax penalty in addition to owing taxes on the funds you used to pay for services your policy doesn't cover.

You should always stay informed about your health coverage, as the items a plan covers can be subject to change from one year to the next. If your plan still covers sleep consulting, you can get those services without incurring any tax penalty. If not, then you can navigate options and select a sleep consultant whose services are most affordable for you.


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