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Hi ksheffielddds!

Great question. Medicare's LCD for oral appliances for OSA states:

"Repairs are covered for items that meet the coverage criteria. To repair means to fix or mend and to put the item back in good condition after damage or wear. Repairs are covered when necessary to make the item serviceable. If the expense for repairs exceeds the estimated expense of purchasing another item, no payment can be made for the excess.

Oral appliances are eligible for replacement at the end of their 5-year reasonable useful lifetime (RUL). These items may be replaced prior to the end of the 5-year RUL in cases of loss, theft, or irreparable damage. Irreparable damage refers to a specific accident or to a natural disaster (e.g., fire, flood). Replacement due to wear-and-tear as the result of everyday use will be denied as statutorily noncovered prior to the expiration of the 5-year RUL."

So most likely, since you are still within the 5 year period, you would be looking at a repair. These items tend to depend on the situation and nature of the breakage, repair, etc. Do you know what the warranty period is for the appliance from the manufacturer that fabricated your the Herbst device? That may be your best route!