Insurance covers diagnosis, treatment of most sleep problems

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The diagnosis and treatment of sleep disorders have come a long way in recent years. In the past, people who snored might be advised to sew a tennis ball onto the back of their pajama top. The "snore ball" would discourage them from sleeping on their back and might quiet their droning. Or a doctor might use the "dog index" to measure poor sleep: If your dog generally sleeps with you but by morning has left the bed more than half the time, it may be because you're such a loud, restless sleeper that the dog has gone elsewhere for some peace and quiet.

How things have changed. Now, doctors with special training diagnose and treat more than 80 sleep disorders -- from obstructive sleep apnea to narcolepsy -- at special centers with labs where a patient's every sleeping moment may be recorded and measured.Insurance usually covers the diagnosis and treatment of sleep problems, with some exceptions. For example, snoring on its own is not a medical problem and insurance won't cover its treatment, to the great disappointment of many a snorer's bed partner.

Obstructive sleep apnea, which occurs in at least 2 to 4 percent of Americans is another matter entirely. The consequences of untreated sleep apnea can be extremely serious.

Sleep apnea is an obstruction of your airway that's created when the muscles at the back of your throat relax during sleep. The obstruction partially or completely stops your breathing, sometimes for a minute or longer, until your brain alerts your body to wake up and you start to breathe again. This can lead to fragmented, poor sleep as well as reduced oxygen levels, which can worsen such medical conditions ashigh blood pressure and diabetes and increase your risk ofheart attack and stroke.

As awareness of the problem has increased, so has demand for testing and treatment. Patients with suspected sleep apnea are typically sent to sleep centers where they are evaluated overnight while they sleep. In the past 10 years, the number of accredited sleep centers has grown from 566 to 2,258, according to the American Academy of Sleep Medicine.

Snoring is a common symptom of sleep apnea, but some experts say sleep studies may be overprescribed. "Everybody who snores doesn't need a sleep test," says Fred Holt, an ear, nose and throat surgeon in Raleigh, N.C., and an expert on sleep apnea who consults on anti-fraud issues for attorneys, medical auditors and investigators. The risk of developing sleep apnea is higher in people who are overweight, male, middle-aged or older, or smokers.

Medicare payments for sleep lab testing have increased from $62 million in 2001 to $235 million in 2009, according to the Department of Health and Human Services' Office of the Inspector General, which is conducting a study to review the appropriateness of Medicare payments for them. The study is due next year.

There are home sleep tests for problem sleepers as well, and their use is also on the rise, say experts. Rather than measure more than a dozen body functions while a person spends the night in a sleep lab hooked up to sensors, home sleep tests measure only a few functions while patients sleep in their own beds. Their cost is a few hundred dollars vs. up to $2,000 for a night in the lab.

Insurance will generally cover either type of test if it is prescribed by a physician. But while home sleep tests may mean a smaller bite out of your wallet if you have a co-payment or a high-deductible plan, they're not the best choice for everyone, sleep experts agree. "Home sleep testing should be reserved for people that are at high risk for sleep apnea and who don't have a lot of other illnesses likeobesity or heart disease that might alter the sensitivity of the test," says Nancy Collop, director of the Emory Sleep Center in Atlanta and president of the American Academy of Sleep Medicine.

Eli Walker snores and sometimes stops breathing for short times while sleeping. Walker, 63, read that there was a correlation between high blood pressure, for which he took two medications already, and sleep apnea. He went to see an ear, nose and throat specialist who sent him to a sleep lab near his Silver Spring home. Diagnosis: moderate sleep apnea.

Walker was prescribed a continuous positive airway pressure mask, which straps onto a person's face and directs pressurized air into the airway, keeping it open. But after three months of trying to use it, he gave up. "I hated it," he says. "I couldn't breathe naturally, and I didn't like the air blowing in my nose."

Walker finally found a good night's sleep with a specially fitted oral appliance that looks kind of like a sports mouth guard. The appliance, which must be fitted by a dentist with special training in sleep medicine, repositions and stabilizes the lower jaw and soft tissues so that the airways stay open. It typically works best with people with mild to moderate sleep apnea.

Good news for seniors: Private insurers have covered the dental appliances for years, according to Sheri Katz, president of the American Academy of Dental Sleep Medicine. In January, Medicare began covering them, too.

Auto Insurance Canceled After Cracked Windshields

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CHARLOTTE, N.C. -- The next time you file a claim for a cracked windshield, it could result in your auto insurance being canceled.
A State Farm customer for several years, Charles Stanford said his car insurance cancellation notice came out of the blue."I never in my wildest dreams thought that I would be dropped for something like that. It doesn't make sense to me,” Stanford said.He said the reason State Farm dropped coverage was a cracked windshield, which actually happened twice in the same month.He said the windshield replacement company chosen by State Farm replaced the glass both times.Stanford said the minor incidents were not his fault and his driving record is clean."(I) don’t have any speeding tickets, no parking tickets, no accidents.

I have absolutely nothing. Why in the world would you cancel me?" he said.Action 9 talked with insurance experts who said it’s rare for most companies to cancel coverage over cracked windshields.These cases, when compared to most minor fender benders, are a modest cost and a freak event and the driver should not responsible."Normally in a case like this they would raise your premium. That woulseem the logical thing to do, but here they've gone to the extreme and dropped them as a client," one expert said.Our sister station in Orlando, WFTV,contacted State Farm, which said “whether a driver is at fault is not the reason for some cancellations.”The company said its underwriting policy includes not renewing customers who have frequent claims within the same year and a family car had a cracked windshield in 2009.

According to Stanford, other companies have offered coverage, some at higher premiums. But no one turned him down over cracked windshield claims."If this is a common thing, the public needs to know about it," Stanford said.

All or nothing for some Allstate customers

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RALEIGH (WTVD) -- Some North Carolina residents say they are concerned, after a major insurance company is threatening to cut them loose.

More than 40,000 Allstate customers have been getting letters in the mail letting them know their homeowner's insurance policies will not be renewed unless they add on auto insurance.
Allstate Customer Ricky Stout says he pays his homeowner's policy each year. He says in all the years he's had Allstate, he never even filed a claim.
"I was very upset because all of a sudden now they are telling me I have to put my auto insurance with them or my homeowner's policy is gone I don't think it's right at all," Stout said.
Stout says he has his auto insurance through another carrier and is happy with it and does not want to make the switch.

"I don't think they're trying to keep me," he said. "I don't think they care."
Stout says he wonders why Allstate is taking this action and if it is even allowed.
ABC11 Eyewitness New I-Team Troubleshooter Diane Wilson reached out to Allstate and a representative says they will not offer the option to renew to about 44,700 North Carolina customers who only have property coverage and not an auto policy.

"More than 400,000 North Carolina customers have purchased insurance products from Allstate, and Allstate takes that responsibility very seriously," said John Heid, Allstate Senior Communications Consultant in the Southeast Region. "Managing our exposure is necessary to allow Allstate to continue to help provide protection and peace of mind through a variety of insurance products."
"At the same time, Allstate proactively seeks out solutions to meet the challenges posed by North Carolina’s insurance market, and to help preserve affordable access to insurance in this state."
"Allstate has made an agreement with Universal North America Insurance Company (Universal). As a part of our agreement with Universal North America Insurance Company, and in an effort to manage our overall risk in the North Carolina property insurance market, Allstate will not offer the option to renew for a segment of North Carolina property customers, most of which will be provided a quote for property coverage with Universal. Beginning with policies that renew on or after June 19, 2011, Allstate will not offer the option to renew to approximately 44,700 homeowner, Landlord’s Package Policy (LPP) and mobile home policies throughout North Carolina that did not also have an active standard Allstate auto policy as of December 15, 2010. The majority of these affected customers will receive a quote from Universal for property insurance coverage."
"These actions were carefully considered, and will help ensure Allstate’s continued ability to provide a wide variety of insurance products to North Carolina consumers at a competitive rate, while remaining financially strong in every community we serve."

A check with the state's department of insurance says Allstate's action is legal, as long asthe company gives the insured 30 days advanced notice of non-renewal.
Stout says he received that notice, but does not understand why Allstate wants to lose his $2,800 homeowner's policy each year.
"I don't understand as my homeowner's insurance is a lot more expensive than my car insurance and I'm like why are they worried about that little bit business," he said.

Deadline nears to apply for FEMA tornado aid

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RALEIGH -- Victims of the April 16 tornadoes that tore through North Carolina have until midnight

Monday to apply for federal disaster aid.
To receive grants and assistance from the Federal Emergency Management Agency and the Small Business Administration, storm victims must apply by calling 800-621-3362 or visiting fema.gov.
Since the storms, 9,128 North Carolina victims have registered with FEMA, and the agency has doled out $15 million.

In Wake County, 2,195 people have registered, and they’ve received $1.45 million in aid. In Johnston County, 460 victims have registered and received $1.01 million.
FEMA spokesman Gene Kauffman worries that some victims are still hesitant to register. “They feel like they haven’t had much damage and they’ve got insurance,” Kauffman said. “If they’re reluctant to come forward, they should not be.”
Kauffman said victims with insurance can qualify if their policy didn’t cover all their losses. Also, registering with FEMA doesn’t affect one’s eligibility for other federal aid programs.

Coalition Issues Warning on Kids and Hot Cars

On average, 35 to 40 children across the country die from heat exposure in vehicles each year.
According to Safe Kids North Carolina, 2010 turned out to be one of the deadliest years on record for children 2 months to 6 years old with 49 hyperthermia deaths.
In the past five years, at least 10 children in North Carolina have died from hyperthermia after being trapped in hot vehicles.
Some of these deaths occur when a parent accidentally forgets a child in a car. Some occur when a parent intentionally leaves a child in a vehicle. In other cases, a child was playing in an unattended vehicle when overtaken by heat.
"Sadly, these deaths are preventable," said state Insurance Commissioner Wayne Goodwin, state chairman of Safe Kids North Carolina. "Leaving a child unattended in a car, even for a minute, is more dangerous than many people realize."
That's why Safe Kids North Carolina has launched a new safety campaign, with the slogan "S'more dangerous than you think... Never leave your child alone in a car." Safety experts show parents, caregivers and children how easy it is to bake a s'more in a vehicle to demonstrate how quickly the inside of a car can become dangerously hot.
With its soaring temperatures, July is historically the deadliest month for cases of vehicular hyperthermia in children in the state, a news release said. However, the danger spreads from March through November due to the subtropical North Carolina climate.
Hyperthermia can occur even on days with mild 70-degree temperatures. The temperature in a closed vehicle can rise about 20 degrees in 10 minutes and nearly 30 degrees in 20 minutes. Cracking a window has little effect.
Safe Kids North Carolina offers the following safety tips:
n Never leave a child alone in a vehicle. Check to make sure all children exit the vehicle when you reach your destination.
n Lock the doors when your vehicle is parked, and store keys in a secure location. Teach children that cars are not places to play.
n Busy parents have a lot on their minds, so give yourself a reminder.
Place your purse, briefcase or other important items in the backseat next to your child's car seat so you have to look in the back before leaving the car. Also, set a reminder on your cell phone or other mobile device to remind you to drop off children when routines change.
n Make an arrangement with your child's school or day care that you will be notified if your child is not dropped off at the normal time.
n If you see a child or pet left unattended in a vehicle, call 911 immediately.
n Check vehicles and trunks first if a child goes missing.
Safe Kids North Carolina reaches out to parents, caregivers and children to prevent childhood injuries through 36 Safe Kids Coalitions working in 64 counties.

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