Inspire Implant Payback Estimator

See whether Inspire hypoglossal nerve stimulation financially beats long-term CPAP therapy. Enter the full procedure cost (including surgeon, facility, and programming fees), the share insurance will cover, your monthly CPAP out-of-pocket spending, and the expected battery life of the Inspire system. The estimator reports patient responsibility, breakeven timing compared with ongoing CPAP purchases, five-year cash impact, and the monthly sinking fund required to cover the next device replacement so you can plan financing or HSA withdrawals ahead of surgery.

Include surgeon fees, facility charges, anesthesia, and device programming.
Share of the procedure paid by your insurer after deductibles and coinsurance.
Average monthly out-of-pocket costs for masks, tubing, filters, electricity, and cleaning supplies.
Years until battery replacement or revision surgery is typically required.

This estimator assumes CPAP expenses stop once Inspire therapy begins and ignores financing interest, tax effects, and clinical eligibility requirements. Review pre-authorization steps, medical guidance, and lender terms with your care team before scheduling surgery.

Examples

  • $32,000 procedure, 70% coverage, $110 monthly CPAP spend, and a 10-year device life ⇒ $9,600.00 out of pocket, breakeven in 87.3 months (7.3 years), five-year impact of -$3,000.00, and $80.00 to reserve monthly.
  • $26,000 procedure, 80% coverage, $180 monthly CPAP spend, and an 11-year device life ⇒ $5,200.00 out of pocket, breakeven in 28.9 months (2.4 years), $5,600.00 saved over five years, and a $39.39 monthly replacement fund.

FAQ

Can I add maintenance visit fees?

Fold routine sleep clinic visits or programming charges into the implant cost so they are reflected in the out-of-pocket estimate.

What if insurance denies coverage?

Set coverage to 0% to model a self-pay scenario and gauge how much CPAP spending you would need to eliminate to justify the switch.

Does the calculator include resale of CPAP equipment?

No. Apply any resale proceeds by reducing the implant cost input or by treating them as an offsetting cash inflow outside the model.

How should I use HSA or FSA funds in the model?

Reduce the out-of-pocket cost by the amount reimbursed through HSAs or FSAs to reflect the net cash impact.

Can I account for financing or medical loans?

Yes. Run the estimator to determine cash payback, then compare the replacement fund output with your loan payment schedule to see whether interest charges offset projected CPAP savings.

Additional Information

  • Insurance coverage applies to the entire procedure cost; include sleep lab studies or appeal fees in the cost input if you pay them out of pocket.
  • Baseline CPAP spending assumes you stand down existing therapy after implantation; add residual supply purchases if you plan to keep a backup machine ready.
  • Five-year savings compare Inspire cash flows with continued CPAP purchases on a nominal basis—add a discount rate externally for NPV analysis.
  • Replacement fund spreads the post-insurance out-of-pocket cost evenly across the expected battery life to simplify monthly budgeting.
  • Breakeven timeline ignores financing interest, tax savings from HSAs/FSAs, or insurance premium changes—layer those in separately if relevant.
  • If your center requires overnight titration stays, fold hotel or travel costs into the total implant cost to reflect the full investment.

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