Commercial · National

Aetna (CVS Health)

Aetna (CVS Health) publishes coverage policies for 4 of the 4 sleep apnea treatments we track. Each is linked to its source document below.

By treatment

CPAP and PAP therapy

Policy published

Prior authorization Not researched

Initial qualification Not researched

Continued coverage Not researched

Utilization management Not required

Policy number — CPB 0004

Effective — 2026-07-21

Read the policy document →

Oral appliance therapy

Policy published

Prior authorization Not researched

Initial qualification Not researched

Continued coverage Not researched

Utilization management Not required

Policy number — CPB 0004

Effective — 2026-07-21

Read the policy document →

Hypoglossal nerve stimulation

Policy published

Prior authorization Not researched

Initial qualification Not researched

Continued coverage Not researched

Utilization management Required

Policy number — CPB 0004

Effective — 2026-07-21

Published utilization-management detail

At least one month of CPAP monitoring with documented failure or intolerance

Read the policy document →

Tirzepatide (Zepbound) for OSA

Policy published

Prior authorization Required

Initial qualification Not researched

Continued coverage Not researched

Utilization management Not required

Policy number — 6450-C P08-2025 v8

Read the policy document →

Last verified 2026-08-15. We record structured facts and link the source; we do not reproduce policy text. The document itself governs.

If you're denied

Aetna (CVS Health) publishes its own appeal instructions. Start there, and note the deadline on your denial letter.

Aetna (CVS Health) appeals process

How to appeal a sleep apnea denial →

Your specific plan may differ from Aetna (CVS Health)'s general policy, particularly if your coverage is through an employer. Policies are revised without notice. Nothing here is a guarantee of coverage or a substitute for confirming with your plan.