Does TRICARE Cover Sleep Studies? 2026 Rules & Costs | TRICARE.com

## Quick answer Yes, TRICARE covers sleep studies to diagnose conditions like sleep apnea, narcolepsy, or restless leg syndrome. To be covered, the study must be ordered by a physician and performed at a TRICARE-authorized sleep center or through an approved home-based kit.

*Note: TRICARE.com is an independent reference site and is not the official TRICARE program or a government agency. For official policy, visit TRICARE.mil.*

Details

TRICARE covers sleep studies (polysomnography) when they are deemed medically necessary to diagnose a specific sleep disorder. Coverage is generally split into two categories: attended (in-lab) and unattended (at-home).

### Medical Necessity Criteria A sleep study is typically covered if you exhibit symptoms such as: * Chronic snoring or gasping for air during sleep. * Excessive daytime sleepiness. * Observed episodes of breathing cessation (apnea). * Suspected narcolepsy or parasomnias.

TRICARE does **not** cover sleep studies for "lifestyle" issues, such as simple snoring without apnea, or if the study is considered "experimental" or "investigational."

### Referral and Authorization Requirements The rules for getting a sleep study depend on your plan: * **TRICARE Prime (Active Duty):** You **must** get a referral from your Primary Care Manager (PCM) and an authorization from your regional contractor (Humana Military in the East or TriWest in the West). Active duty service members usually receive these tests at Military Treatment Facilities (MTFs). * **TRICARE Select / TRS / TRR:** You do not typically need a referral, but the sleep center must be TRICARE-authorized. Some versions of sleep studies may still require prior authorization to ensure medical necessity.

### Home Sleep Apnea Testing (HSAT) TRICARE covers unattended home sleep studies if you have a high probability of moderate to severe obstructive sleep apnea (OSA). These kits are often preferred by contractors because they are more cost-effective than overnight stays in a lab.

### Costs for 2026 Your out-of-pocket costs depend on your beneficiary "Group" and plan type: * **Active Duty Service Members:** $0. * **TRICARE Prime (Retirees/Families):** No cost if referred. If you use Point of Service (POS) without a referral, 2026 rates apply (usually a $300 deductible plus 50% of the allowed cost). * **TRICARE Select (Group A):** For 2026, network copays for specialty office visits or outpatient procedures apply (e.g., ~$30–$50). * **TRICARE Select (Group B):** Copays generally range from $32–$65 for specialty care in 2026.

### CPAP Coverage If a sleep study confirms a diagnosis of Obstructive Sleep Apnea, TRICARE covers the Rental or Purchase of a CPAP or BiPAP machine, as well as replacement supplies (masks, tubing, filters) on a set schedule.

## Who this affects * **Active Duty Service Members:** Full coverage (requires referral). * **National Guard and Reserve:** Covered under TRICARE Reserve Select (TRS). * **Retirees and Families:** Covered under TRICARE Prime, Select, or TRICARE For Life. * **Survivors and Medal of Honor Recipients:** Eligible under standard medical benefit rules.

## Sources * **TRICARE.mil:** [Sleep Studies Coverage Details](https://www.tricare.mil/CoveredServices/IsItCovered/SleepStudies) * **Humana Military (East):** [Sleep Study Authorization Guidelines](https://www.humanamilitary.com) * **TriWest Healthcare Alliance (West):** [Provider and Beneficiary Services](https://www.triwest.com) * **Defense Health Agency (DHA):** [CPAP and Sleep Apnea Policies](https://health.mil)