Can I use health insurance for a sleep study? 

Almost half of Australian adults experience sleep problems regularly, and if you or a family member is one of them, there are treatments available. The good news is that some treatments for sleep apnoea and other sleep issues are covered by health insurance.   

Does health insurance cover sleep studies? 

A sleep study is where you’re observed as you sleep, to assess whether you have a condition such as sleep apnoea. You can do this under Medicare at a public hospital or clinic, but if your sleep study is in a private hospital or clinic, it may be covered by health insurance if your Hospital Cover policy includes the Sleep Studies clinical category. Using the healthslips.com.au calculator to find the cheapest health insurance for sleep studies for one adult in NSW, we found a Bronze Plus policy for $121.20 per month with a $750 excess. 

Remember, there may be a Gap for sleep study claims if you’re treated as a private patient, although it shouldn’t be high. According to Medical Costs Finder, the average Gap for sleep study claims in 2022-23 was $20. And if you already have signs of a sleep problem that requires a sleep study, there will be a 12-month waiting period for pre-existing conditions before you can claim. 

Does health insurance cover CPAP machines for sleep apnoea? 

Around 5% of Australians have sleep apnoea, a condition where you stop breathing repeatedly during sleep, which is especially common in men over the age of 30. If you need a CPAP (continuous positive airway pressure) machine for sleep apnoea, you may be able to get some of the cost covered by Medicare (ask your doctor if you’re eligible). You might also be able to claim some costs on your health insurance, depending on your insurer. Some insurers offer CPAP cover as an extra benefit to people who meet certain conditions, so it’s best to contact your insurer directly and ask whether you’re covered. 

Does health insurance cover sleep school for babies? 

If you’re having trouble getting your baby to sleep, your doctor might recommend a residential stay at an early parenting centre, commonly known as ‘sleep school’. If it’s a public sleep school, Medicare will cover the cost. If it’s a private sleep school, Medicare will only cover part of the cost – but if you have the right level of cover, you may be able to claim it on health insurance.  

Health cover for sleep school depends on your insurer and the facility. You’ll need to have cover for both you and your baby, and there may be limits. We recommend you call your insurer and the sleep school to find out their process.  

What’s the best health insurance for sleep studies? 

The best health insurance for sleep studies is the one that meets your budget and healthcare needs. And the easiest way to find that is using the healthslips.com.au calculator to search every policy in Australia, for free, without entering any contact details. We have no commercial bias and we’re not selling insurance, so you can trust our calculator results. Try the healthslips.com.au calculator to search for a new policy or compare your existing policy to others available.  

healthslips.com.au does not provide general or personalised advice. Your particular circumstances are likely to impact the accuracy, completeness and relevance of the information or results. Take this into account before making a decision and talk to an expert for financial advice. 

Trudie McConnochie

Writer and Researcher

Knowledge is power – that’s the guiding principle behind everything Trudie writes, and it’s a philosophy she brings to her work at healthslips.com.au. By breaking down complex information into easy-to-understand blogs and stories, she aims to empower Australians to make the best choices and an informed decision around private health insurance.

Trudie understands firsthand some of the complexity of private health insurance having moved to Australia from New Zealand and having to navigate a vastly different public healthcare system and health insurance structure.

Trudie holds a Bachelor of Communication Studies (journalism major) from the Auckland University of Technology.

Read more.